A series oof 233 patients resected between 1973-1993 were reviewed. In the postoperative staging we found 109 stage I, 29 stage II, 89 stage III and 6 stage IV.

Group of tumors in stage III were formed by the following types:

T1-2 N2 = 35, T3 N0-1-22 = 31, T4 N0-1-2=22 and T3 N3 = 1. Fifty-four patients with locally advanced tumors with or without lymph node metastasis were analyzed. All of them were male and the ages varied between 30 and 75 years.

The histologic types were:

Epidermoid Carcinoma 35, Adenocarcinoma 14 and Undifferentiated Large Cell Carcinoma 5.

Resection was indicated in:

tumors next to the carina (2), atelectasis of the left lung (3), resections extended to the chest wall (30) and in 23 cases the resection included one or more mediastinal structures. We performed 23 lobectomies, 26 pneumonectomies and 5 atypical resections. Between 1973-1985, only presumably pathologic lymph nodes were excised, whereas in the period of 1986-93 systematic mediastinal dissection was used in all cases. Six patients in stage IV were operated on, 3 with intrapulmonary metastasis, 2 with brain metastasis and one with subcutaneous metastasis. The postoperative mortality was 9 percent and the morbidity 13 percent. The overall 5-year survival of patients with advanced tumors was of 23 percent; one of the patients in stage IV is still alive 26 months after surgery. The best results were obtained in the cases of tumors extending to the lateral chest wall, with a 5-year survival rate of 29 percent increasing to 41 percent in the subgroup T3-4 N0. The patients who presented with invasion of mediastinal structures had a 5-year survival of 12 percent.