The patient, Ms. Xia, is 62 years old and just retired more than 6 years ago when she was found to have intestinal cancer. Fortunately, the tumor was detected in time and was successfully removed by a highly respected surgical specialist, and chemotherapy was completed as required after the surgery. She was followed up regularly. However, unfortunately, the tumor recurred in less than two years, and CT was done to find out that there was another lesion in the cecum area, and the tumor index was gradually increased by blood test. After careful consideration, under the doctor’s suggestion, Ms. Xia bravely underwent the second surgery to remove the appendix and ovaries, and the surgery was complete. After chemotherapy again, her body recovered well and the family happily went out for a vacation. The tumor recurrence haunted her like the devil, and she underwent two more surgeries and subsequent radiotherapy treatments in three years because of the tumor recurrence. Poor Ms. Xia’s health deteriorated and her weight dropped from 120 pounds to 90 pounds. However, the disease did not break her down, she became extremely brave and maintained her optimism and tenacity during the five years of struggle with bowel cancer. In the sixth year after the disease, Ms. Xia’s disease recurred again, and PET/CT showed that metastatic lesions appeared again in the pelvis, uterus and small intestine. After seeing the report about the successful experience of multidisciplinary treatment of advanced intestinal cancer in Shanghai Sixth People’s Hospital, she visited Dr. Wang Zhigang, the director of gastrointestinal surgery, for consultation. After discussing with the multidisciplinary team of medical oncology, radiotherapy, imaging, gynecology and urology, Dr. Wang analyzed that although Ms. Xia had multiple recurrences of intestinal cancer, the lesions were still relatively limited and not combined with metastases to the liver and lung, so there was still hope for surgical resection, and the assessment of her general condition and vital organ functions could tolerate the surgery. So, the ureteral catheter was left in place by Director Zhang Xinru of the Department of Urology, and Director Wang Zhigang was in charge of the operation. In cooperation with Director Zhang Rui of the Department of Gynecology, the recurrent tumor was successfully resected again through complex adhesion release and combined with organ removal, and part of the small intestine, uterus, peritoneal tumor cell annihilation, and lateral pelvic lymphatic clearance were removed to achieve complete resection of the tumor. Up to now, it has been nearly one year since the follow-up, and no sign of recurrence has been found in all reviews. With the development of China’s economic level and changes in lifestyle and diet structure, the incidence of colorectal cancer in China has increased year by year in recent years, becoming one of the most common malignant tumors affecting people’s health and life in China. Therefore, the treatment of colorectal cancer is getting more and more attention. After years of clinical research at home and abroad, it is shown that the treatment of colorectal cancer has its own characteristics and rules, and it is not as simple as “surgery immediately after detection”. How to use the combination of all the current tools against bowel cancer, including surgery, radiotherapy, chemotherapy and targeted therapy, is crucial to the treatment effect of bowel cancer patients. Compared with European, American, Japanese and Korean countries, the 5-year survival rate of bowel cancer patients in China is lower after surgery, which is not only related to the late detection of disease due to insufficient colonoscopy screening and more progressive cases, but also to the lack of standardized multidisciplinary treatment (MDT). This also leads to significant differences in the outcome of bowel cancer treatment in different regions of China. In fact, in large and medium-sized cities where medicine is more developed, bowel cancer surgery, including traditional surgery and various minimally invasive surgeries represented by laparoscopy, has been relatively mature, and the surgical skills of domestic colorectal surgeons are completely equal to or even better than those of European and American doctors. However, due to various objective and subjective factors, the popularization of this internationally accepted multidisciplinary model is relatively slow in China. This is not only related to the different subspecialty system of hospitals in China and the updating of doctors’ knowledge and philosophy, but also the patients’ understanding, acceptance and compliance have hindered the implementation of this optimal model to some extent. For early-stage bowel cancer patients, direct colonoscopic or laparoscopic surgical resection, followed by deciding whether adjuvant treatments such as radiotherapy and chemotherapy are needed based on pathological results and formulating standardized follow-up and review programs are sufficient, which are relatively simple and do not require the so-called MDT process. However, unfortunately, more than 80% of patients with bowel cancer in China are in the middle and late stage or progressive stage, and even 20% of them already have distant organ metastasis or local invasion when they are found. In this case, if they directly enter the surgical procedure without MDT discussion, they are likely to take a detour and lose the opportunity to obtain good results otherwise. MDT usually involves specialists from colorectal surgery, medical oncology, radiotherapy, radiology (sometimes pathology is also required), etc. Through a series of examinations, a comprehensive assessment of the patient’s condition is made, including the site, type, stage, distance to Based on the results of these assessments, clinical pathways and treatment strategies will be formulated with reference to existing guidelines, such as whether surgical resection should be followed by radiotherapy or radiotherapy followed by surgery, whether targeted therapy should be added, which combination of chemotherapy and targeted therapy should be used, and which combination of chemotherapy and targeted therapy should be used. For example, whether to add targeted therapy, which combination of chemotherapy and targeted therapy, how to evaluate the efficacy, timing of surgery, scope of surgery, whether to remove metastases in one stage or two, whether to combine with organ removal such as ovaries, whether to perform lumpectomy or open surgery, whether to preserve anus, postoperative adjuvant radiotherapy regimen, and how to reduce perioperative risks. The above is only a general introduction and understanding of multidisciplinary treatment (MDT). Director Wang Zhigang of the Department of Gastrointestinal Surgery of Sixth Municipal Hospital firstly explained MDT for bowel cancer into three ladders, i.e. three-step MDT for bowel cancer treatment. The first ladder, that is, the multidisciplinary team consisting mainly of surgical oncology, internal medicine, radiotherapy and radiology, which is common at home and abroad, assesses the condition of a first-time bowel cancer patient and formulates the treatment process and strategy, as mentioned above, which is the model being actively promoted by most bowel cancer centers in China, and is basically similar. In the second ladder, if a patient enters the surgical process directly or after preoperative radiotherapy and/or targeted therapy (which can be neoadjuvant or translational therapy), perioperative safety control is crucial to the success of the surgery, which requires more close cooperation of multidisciplinary teams, including cardiology, pulmonology, anesthesiology, ICU, etc. Currently, the advanced age of patients in China (the average age of intestinal cancer patients in Shanghai For these elderly and high-risk bowel cancer patients, Director Wang believes that the joint efforts of the multidisciplinary team before and during surgery (perioperative period) cannot be overemphasized, which is a necessary guarantee for the medical quality of a center. What is more worth mentioning is the third ladder, that is, in view of the current situation that China’s bowel cancer is mainly middle and late stage cases and the high recurrence rate of bowel cancer after surgery (more than half of the patients will have recurrence and metastasis after surgery), for such locally advanced or metastatic bowel cancer cases and recurrence after surgery, resection of tumor is the best choice under the first ladder, but the surgery is difficult, technically demanding, risky and requires multiple surgical departments to work together. This is the concept of multidisciplinary surgical departments, which was first proposed by Dr. Wang. For these complex cases, joint attack and hybridization of techniques from different departments are often the only way to reach radical tumor resection and possibly long-term survival. According to Dr. Wang Zhigang, the concept of three-step MDT is a useful supplement to the current classical MDT concept of bowel cancer, which enriches the connotation of MDT for bowel cancer and allows experts from more departments to participate, share resources and join forces to truly put the patient as the center and integrate all advantageous technical forces to improve the surgical resection rate and safety of bowel cancer patients, thus prolonging postoperative survival and improving life quality. Three-step MDT discussion is necessary for the treatment of complex bowel cancer mentioned above. In addition, the hospital also offers a wide range of services, such as the following: the treatment of rectal cancer, the combination of liver and lung metastases, rectal cancer requiring ultra-low and extreme anal preservation, intestinal cancer combined with other intestinal diseases such as ulcerative colitis, familial polyposis, other rare colorectal diseases such as neuroendocrine tumors, sarcomas, mesenchymal tumors, and rare middle pelvic tumors. For this reason, the hospital has set up the “complex intestinal cancer multidisciplinary diagnosis and treatment integration clinic” to move the diagnosis and treatment of complex colorectal cancer to the outpatient clinic, which has a working secretary in addition to the experts from the above departments for the convenience of patients, so that patients can get the opinions from multidisciplinary experts in one visit, avoiding the difficulties of making outpatient appointments and multiple visits. It avoids the trouble of difficult outpatient appointments, multiple visits, and the hassle of multidisciplinary discussions and then transferring to other departments after hospitalization. After making an appointment, patients can provide complete case information, imaging data, previous medical and surgical records, etc., which greatly improves the efficiency of consultation. Patients can make appointments for this integrated clinic by phone at the appointment center, on the website of the Sixth Hospital, through the secretary’s email address, or through the specialist’s personal medical website.