Therapeutic and prognostic problems in lung cancer with mediastinal lymph node involvement

From January 1st, 1978 to 31st December, 1981, 28 patients with lung cancer and mediastinal lymph node metastases, underwent surgery. In four patients, only exploration was performed, in five patients, an incomplete resection and in 19 patients, a complete resection (resectability rate 86%). In the first two groups of patients, survival never exceeded two years. In the 'complete resection' group, 78% of the patients survived for one year, 61% for two years and 47% for three years. Patients with adenocarcinoma had a higher three year survival rate than those with squamous cell carcinoma (60% vs. 37%). No 30-day mortality was observed. All patients were treated postoperatively with MACC + BCG. The prognosis of lung cancer classified as N2 is strongly influenced by a series of factors some of which are included in the TNM system. In any case, it would still appear that the best treatment for this kind of tumor is radical surgical resection followed by adjuvant radiotherapy and/or multichemotherapy.