Lung cancer that can be surgically removed is more fortunate! Pre-operative lung cancer that is judged to have a chance of surgery is not always cut down smoothly, there are also times when the chest is simply opened and explored, which is commonly referred to as “too late”, “flying”, “opened and closed “, etc. This percentage is about 5%; with the development of modern medicine, this percentage is decreasing. For patients who already have pleural multiple metastases and still go for lobectomy, instead of benefiting from the surgery, the patient will accelerate the deterioration. Except for intrapulmonary or pleural multiple metastases that are not suitable for surgery, the vast majority of the remaining lung cancer open-heart surgery cases should be resected as completely as possible. The goal is to increase the surgical resection rate and the degree of radical resection, i.e., to remove as much as possible, so that more patients may have a chance to be cured. Moreover, we emphasize that for lung cancer that can be surgically resected, the thoroughness of resection is very important. In addition to removing the lung lobe where the cancer is located, the lung cancer surgery must also involve complete removal of mediastinal lymph and adipose tissue, which is defined by international standards as “standard lung cancer surgery, including lobectomy, plus local lymph and adipose tissue clearance in the hilum and mediastinum”. The scope of clearance is clearly defined. (See previous presentation: How many groups of lymph nodes should be removed for lung cancer surgery?) If the mediastinal lymphatic and adipose tissue clearance is not complete, it also means that there may be cancer left behind and not cut. If the number of lymph nodes removed is not enough and does not meet the standard, the resection is not complete and not clean. If the mediastinal adipose tissue is simply removed or “pulled out” or “removed”, but not completely “removed”, it is also incomplete resection and not clean; data show that compared to lung cancer patients with incomplete lymph node removal, lung cancer patients with complete mediastinal lymphatic adipose tissue removal have significantly higher survival rates. Therefore, lung cancer patients are lucky to have surgery, and even luckier to have clean surgery!