From July 1979 to July 1986, 215 patients with non-oat cell carcinoma of the lung were treated by surgery at our institution. Of these, 169 had complete, potentially curative resection of their primary tumor and all accessible mediastinal lymph nodes. The extent of pulmonary resection consisted of pneumonectomy in 70 patients, lobectomy in 78 patients, bilobectomy in 18 patients and wedge resection in 3 patients. All were staged according to the AJG staging system. There were 88 patients without lymph node metastases (N0), 10 patients with peribronchial lymph node metastases (N1) and 60 patients with regional lymph node metastases (N2). All patients with N2 disease received radiation therapy to the mediastinum after surgery. The overall survival rate was 62% at 1 year, 36% at 3 years and 27% at 5 years. Survival in patients with N2 disease was 56% at 1 year, 23% at 3 years and 12.4% at 5 years. We conclude that patients with mediastinal lymph node metastases can be effectively treated by combined resection and radiation therapy, with prolonged survival.
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