Focusing on reports in patients with SSTs and mediastinal lymph node involvement (Table 1), N2 disease (either clinical or pathologic) was present in up to 25% of cases. In most of the studies, no specific data were reported on the N2 population. In four studies,5,11,14,16 N2 status was grouped with other forms of lymph node involvement (N1 or N3) without specific N2 subanalyses. In two of these reports, lymph node status was not associated with survival.11,16 In three studies with N2 subanalyses,10,13,18 N2 disease was associated with poor survival in these studies with a low rate of induction therapy (only 10%-15% receiving trimodality treatment and 35%-46% receiving no induction therapy).10,13 In one study with a 100% trimodality therapy rate, including 19% N2 disease (either clinical or pathologic), 2-year survival between N2 and no N2 disease was not significantly different (40% vs 52%, P = .50).18 These data should be interpreted with caution because they are liable to selection and other biases. Nevertheless, they show that surgery on N2-positive SSTs is feasible with an acceptable outcome.