Whether centralized lung adenocarcinoma stage 3a can be operated or not depends on patient’s specific condition, if the patient’s physical condition is not good, surgery is not recommended, if the patient’s physical condition is good and the metastatic lesions are less, surgery can be considered. Patients with stage 3a central lung adenocarcinoma can tolerate surgery if there is a single mediastinal lymph node metastasis. They can undergo radical surgical resection for the primary lung lesion and a single mediastinal lymph node metastasis, with chemotherapy and radiotherapy for comprehensive treatment, and the five-year survival rate will be around 30%-50%. If patients with stage 3a central lung adenocarcinoma are older, in poor physical condition, unable to tolerate surgery or difficult to be completely removed by surgery, they may not consider surgery for the time being, but can control the progression of the disease through chemotherapy, radiotherapy, immunotherapy, targeted therapy and so on. Patients diagnosed with centralized lung adenocarcinoma stage 3a should go to the hospital for consultation and active treatment so as not to delay the condition.