Often patients and family members yell at me: we are stage Ia what stage is early anyway, sometimes I can only laugh bitterly. In fact, we cannot believe in the clinical pathological staging. Take gastrointestinal cancer as an example, the current pathological staging focuses on the level of lesion invasion, whether there are distant lymph nodes and organ metastases, but it cannot take into account factors such as cellular malignancy, and I guess the permutation would be too big if all of them are taken into account. Therefore, I often ask the patient to provide a complete postoperative pathology report. I have to look at the degree of cell malignancy, the depth of invasion, whether there are cancer cells left in the surgical incision, whether the lymph nodes are far away from the lesion, and whether there are invasion of blood vessels, nerves, lymphatic vessels and vasculature, and so on. If the cells are poorly differentiated, including indolent cell carcinoma and mucinous adenocarcinoma, they are often highly malignant; the deeper the level of invasion and the more distant the lymph node metastasis, the more advanced the disease is; the infiltration of blood vessels, nerves and lymphatic vessels and the presence of cancer clots in the vasculature are all high-risk factors. The presence of these conditions often means a high chance of recurrence and metastasis. If there are cancer cells left in the surgical incision, it means that it is not a radical surgery and should be treated more urgently. The post-operative pathology report can tell us how far the patient has reached at the time of surgery and whether the chance of recurrence and metastasis is high, so please bring the complete medical history including the post-operative pathology report to the first visit.