Eighty patients were treated by resection for carcinoma of the lung with mediastinal lymph node metastases. Complete resection of the primary tumor and a mediastinal lymph node dissection were performed on all patients. The majority also received postoperative external radiation therapy to the mediastinum. Survival after resection was 47% at 3 years and 38% at 4 years. Survival was better when the histologic diagnosis was adenocarcinoma, when the primary tumor was small, and when the mediastinum appeared normal on regular chest roentgenograms. © 1981 Société Internationale de Chirurgie.