Primary lung cancer surgery in stage II and stage III

We reviewed 100 operations performed on 95 consecutive patients with stage II (n = 7) and stage III (n = 88) primary lung cancer. The five-year survival of patients with N1 involvement was 58% and with N2 disease was 21%. Of 13 patients with Pancoast or chest wall involvement, 58% survived five years. The entire group had a 34% five-year survival and a median survival of 32 months. Preoperative and/or postoperative radiotherapy, in the presence of nodal disease, appears to improve local control, but an effective chemotherapy program is needed for unrecognized visceral metastases. In the absence of contraindications, surgical excision offers the best likelihood of survival and quality of life.