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The data of all patients diagnosed and/or treated for lung cancer at the Zürcher Höhenklinik Wald in the years 1977 to 1984 were analyzed retrospectively. In 1986 follow-up interviews were conducted with surviving patients and physicians of all patients. Quality of life was assessed by a performance scale in three stages, adapted from Karnofsky. Overall survival in the 267 patients (age 65 +/- 10 years, 85% males, 91% smokers) was 18 months. 14 patients have thus far lived longer than 5 years after diagnosis, resulting in a 5-year survival (Kaplan-Meier) of 9.6%. Statistical analysis showed survival to be significantly influenced by the performance scale and stage of disease at the time of diagnosis. Decision trees or algorithms calculated with a new computer program (CART) established the importance of performance scale, stage of disease and patients' age, followed by histology and patient's sex for therapeutic decisions and prognosis in lung cancer. Surgical resection in stage I and II was feasible in 20% of all patients only, with a 5-year survival rate of 36%.