Rebuttal From Drs Tanner and Silvestri.

The article presents a response to arguments in favor of adding surgery to standard-of-care chemoradiotherapy alone for treatment of patients with superior sulcus tumor (SST) and mediastinal (N2) lymphadenopathy. Topics covered include the reference made to studies in which trimodality therapy was used in patients with SSTs and N2 disease, the conduct of studies which confirm that N2 disease is an adverse prognostic factor and the call for surgery for SSTs with N2 involvement.