Lung cancer with ipsilateral mediastinal lymph node metastasis has a chance to be operated, and it can be operated, and very many patients have better healing after surgery. Of course, after surgery, patients need additional chemotherapy, radiotherapy, targeted therapy and even immunotherapy, without these treatments, most patients will have recurrence or metastasis after surgery. If it is accompanied by contralateral mediastinal lymph node metastasis will lose the chance of surgery, no longer have the chance of radical surgery, chemotherapy, targeted therapy or immunotherapy before surgery. If it is sensitive to treatment and can be downstaged and the metastatic lymph nodes are not there, there is still a chance of radical surgery, so lung cancer with mediastinal lymph node metastasis is not necessarily inoperable.