Thoracic adenocarcinoma and thoracic neuroendocrine tumors are rare and usually require surgical resection. Currently, there are no guidelines regarding the extent of lymph node dissection during resection of thoracic adenocarcinoma and thymic neuroendocrine tumors. In addition, the prognostic significance of lymph node metastasis in this group of patients is unclear. In view of this, Professor Weksler et al. from the United States conducted a study to determine the incidence of lymph node metastases in patients with thymic carcinoma and thymic neuroendocrine tumors and their correlation with prognosis, which was published in a recent issue of JTO. The study collected clinicopathological data from the Surveillance, Epidemiology and End Results (SEER) database of patients with thymic carcinoma or thymic neuroendocrine tumors who underwent surgical resection. The study analyzed the rate of lymph node metastasis in patients and its impact on prognosis. The investigators identified 176 patients with pathologically definite thymic carcinoma and 53 thymic neuroendocrine tumors. The median number of lymph nodes sampled was 3 per case, of which 92 patients (40.2%) had at least one clear lymphatic metastasis. Patients with thymic neuroendocrine tumors had a higher rate of lymph node metastasis compared to thymic carcinoma (62.3% vs. 33.5%). Multivariate analysis showed that lymph node metastasis was more common in patients with thymic neuroendocrine tumors and more advanced tumors. Lymph node metastasis was an independent prognostic factor that significantly affected the survival time of patients. The median survival time was 47 months for patients with lymph node metastasis and 124 months for patients without lymph node metastasis, a significant difference. Therefore, this study suggests that lymph node status in patients with thymic carcinoma and thymic neuroendocrine tumors is an independent risk factor for prognosis. Lymph node dissection should be routinely performed during surgical resection of this part of thymic malignancy in order to clarify postoperative staging, treatment options and determine prognosis.