From January 1981 through December 1989, 15 patients with small advanced lung 
cancer were treated surgically at the Tenri Hospital. In these cases, the 
diameter of peripheral lung cancer did not exceed 3.0 cm (T1) and mediastinal 
lymph nodes were proved to be N2 postoperatively by lymph node dissection or 
sampling. The histological types were as follows: 8 adenocarcinoma, 4 large cell 
carcinoma, 1 squamous cell carcinoma, 1 small cell carcinoma, and 1 
adenosquamous carcinoma. All but one patient were received postoperative 
chemotherapy and/or radiotherapy. The survival rate was 44.5% at 3 years, and 
median survival time was 36 months. The mediastinal lymph node metastasis with 
small peripheral lung cancer (T1N2) was ominous, and it should be said that 
complete mediastinal lymph node dissection and adjuvant therapy were 
indispensable to small advanced adenocarcinoma of lung.