[T4 lung cancer: surgical indications based on results of surgical treatment]

During the period of 1981 and 1995, 54 patients with T4 lung cancer underwent pulmonary resection in our institutes. The actuarial survival rate of them was 30% at three years and 12% at five years. The five-year survival rate of 12 patients with complete resection was 33%. On the other hand, the five-year survival rate of 30 patients with incomplete resection was 9%. The five-year survival rates of 17 patients with N0 disease, 9 patients with N1 disease, and 22 patients with N2 disease were 13%, 40%, and 5%, respectively. There was a significant difference in survival between patients with N1 and N2 disease. Four patients survived for more than five years after the operation : two patients had invasion to the left atrium and two had a slight degree of pleural dissemination. Radical pulmonary resection may yield long-term survival in T4 lung cancer patients having invasion to the left atrium.