Patients with stage IIIa non-small cell carcinoma of the lung who could benefit from surgical treatment include those with tumors that invade chest wall, diaphragm, or mediastinum, as well as patients who present with mediastinal lymph node involvement. As long as surgery remains the most effective mode of treatment in non-small cell lung carcinoma, it is important that it be made available, when indicated, to the greatest number of patients possible. The continuing high incidence of deaths due to distant metastases underscores the need to combine effective chemotherapy and radiotherapy with the surgical treatment.