All evaluable patients (n = 920) with primary non-small-cell lung cancer (NSCLC) who were presented for surgery in our hospital between 1969 and 1985 were reviewed as to histological findings, postoperative stage, age group and surgical procedure. Time trend analyses showed a significant increase over time in the proportion of adenocarcinomas (p = 0.025) and in the proportion of the elderly (greater than or equal to 70 years; p = 0.014). The 5-year survival rates by year of operation showed no improvement at all over time; on the contrary they showed a decline, which however only reached significance for patients who underwent pneumonectomy (p = 0.034). It is noted that the overall survival curves up to 5 years showed no significant differences between patients with adenocarcinoma and patients with squamous cell carcinoma, or between patients aged 70 years or more and patients aged 60-69 years. Despite expanded preoperative diagnostic techniques and developments in surgical treatment, no improvement in the survival after surgery for NSCLC over the period 1969-1985 could be established.