While the development of chemotherapeutic agents has lead to progress in the treatment of small-cell carcinomas of the lung, the number of local recurrences still remains high. Surgery in tumors stage I and II followed by postoperative chemotherapy is the treatment of choice and has been accepted worldwide. In tumors stage IIIa, especially in T1-3 N2 we obtained good results in the projected 3-year survival using a multimodality therapeutic regime consisting of neoadjuvant chemotherapy (3 cycles preoperative) and surgery as well as postoperative chemotherapy and irradiation of the mediastinum. Projected 3-year survival was 67% in stage I tumors, 42% in stage II and with our multimodality therapeutic regime 38% in stage III a tumors.