In the gastrointestinal surgery clinic, the most common situation encountered is that the patient’s family takes the patient’s information and asks: Doctor, can the patient still be operated? Do you want chemotherapy? I will answer here from the following aspects: 1. Not all gastric and intestinal cancers require surgery in the traditional sense For the diagnosis and treatment of a gastrointestinal tumor, the first thing to do is to stage and evaluate through gastroscopy, ultrasound endoscopy, CT or MRI. For very early lesions, transabdominal surgery in the traditional sense is not required. For some patients with postoperative pathology suggesting tumor remnants at the cut edge, remedial partial gastrectomy or intestinal resection can be done via laparoscopy. 2.Not all gastric and intestinal cancers have the chance of surgery. First of all, in terms of tumor treatment principle, surgery is a regional treatment. If the lesion has distant metastasis such as liver, lung, bone, etc., the preoperative stage is advanced, and usually speaking, surgery only removes the lesion of stomach or intestine is not significant and cannot improve the patient’s survival. The important thing at this time is that a multidisciplinary and comprehensive treatment is needed to prolong the survival time of the patient. There are also some patients who, after effective comprehensive treatment, may be given another chance for surgical radical treatment. For example, a patient with extensive liver metastases from colorectal cancer, after effective comprehensive treatment, the liver metastases are significantly shrunk and reduced, and surgical resection is recommended if surgery can achieve complete resection of all lesions (usually less than 5). The 5-year survival rate of liver metastases treated with surgery can reach 25%, while the median survival of patients without treatment does not exceed 1 year. Secondly, the patient’s physical condition needs to be evaluated. If the patient has serious heart, lung and brain disorders that cannot tolerate surgery and are contraindicated to surgery although the cancer can be removed, surgery is also not recommended. 3.The decision of chemotherapy for gastric cancer and intestinal cancer is based on the stage. Outpatients often ask whether patients need chemotherapy. Scientifically speaking, the choice of chemotherapy or not is based on the recommendation of international clinical practice guidelines. If distant metastases have occurred in the preoperative evaluation, there is no chance of surgery and a combination of treatments such as chemotherapy is recommended. For patients who have surgery, it is necessary to wait for the pathological staging after surgery to decide whether the patient needs chemotherapy. Clinical guidelines are usually developed with reference to international high-level large sample of evidence-based medical evidence. Therefore, patients are advised to follow the recommendations of the guidelines, as they are a summary of a large number of previous experiences and lessons learned. In addition, pre-surgical chemotherapy or radiotherapy may be required for some gastrointestinal tumors. For example, for rectal cancer, if the preoperative MRI stage is T3c or above, the current guideline is to recommend preoperative radiotherapy because it can reduce the local recurrence rate after surgery. Of course, if the patient is elderly, in poor health or has severe surgical complications, he or she may not be able to tolerate chemotherapy after surgery and may be forced to go without it. In conclusion, for a patient with gastric or intestinal cancer, the decision of whether to operate, whether to operate, and whether to have chemotherapy or not is based on the scientific assessment of preoperative and postoperative staging, as well as the patient’s physical condition, and needs to be treated differently. We hope the above answers will be helpful to our patients and friends.