The treatment of lymph node metastasis of lung adenocarcinoma should be better according to the specific stage and specific treatment. stage 2a lung adenocarcinoma treatment is preferred to lung lobectomy plus mediastinal lymph node dissection in the hilum. stage 2b patients should include lobectomy of invaded soft tissues or whole lung and mediastinal lymph node dissection, those with tumor residue should be treated with radiotherapy after surgery, radiotherapy is not recommended after radical surgery. stage 3a patients are more reasonable treatment, including lobectomy of invaded soft tissues, plus mediastinal lymph node dissection, radiotherapy after surgery can reduce the local recurrence rate. Patients with stage 3b and 4 should be given a combination of chemotherapy, radiotherapy, immunotherapy, and Chinese medicine and herbal medicine based on the results of genetic testing and immune testing sites.