Developed by mesothelioma expert Dr. Eric Butchart, the Butchart System of mesothelioma staging is the oldest of the mesothelioma staging systems, and even today it is a widely used and trusted method for determining the extent of mesothelioma development.

The Butchart System consists of four progressive levels, each of which represents the extent to which the primary mass or tumor has spread within the body. The Butchart System largely ignores secondary tumors and medical complications caused by the presence of cancer in the body.

As with most cancer staging systems, the Butchart System is divided into 4 distinct stages. They are:

Stage I - This designation is given when the primary mass or tumor is located in either the right or left pleura and occasionally the diaphragm on the same side. Specifically, growth of the mass has been restricted to only one side of the body.
Stage II - Mesothelioma is said to be in this stage when the mass is present in both of the lungs or the chest wall. In many cases of Stage II mesothelioma, the presence of the primary mass will have extended into the esophagus, heart, or the lymph nodes located in the chest.
Stage III - This designation means that the primary mass has penetrated the bounds of the diaphragm and has reached the peritoneum, or abdominal cavity. At this point in development, the cancer may have spread to the lymph nodes outside the chest.
Stage IV - At this point, the cancer has spread through the bloodstream to other parts of the body. This stage is known as "distant metastatic cancer."

Sources:

http://www.mc.vanderbilt.edu/root/vumc.php?site=thoracic&doc=3594

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