The “sandwich” method is the preferred method for treating “locally advanced” gastrointestinal cancers. 1.After the diagnosis of esophageal, gastric and rectal cancers, do not rush to surgery! Scientific and systematic evaluation and correct staging before surgery are very important. Remember: qualitative diagnosis is important, and staging diagnosis is more important. Many patients with esophageal, gastric and rectal cancers are found to have obvious lymph node metastasis after enhanced CT of chest and upper abdomen and enhanced CT of pelvis or MRI or ultrasound endoscopy. How to treat these patients scientifically? Is it immediate surgery? The answer is no. According to the latest international research progress, the best treatment mode for patients with locally advanced esophageal, gastric and rectal cancers with lymph node metastasis is to have chemotherapy and radiotherapy before surgery, followed by radical surgery, and then appropriate chemotherapy after surgery. This method of treating locally advanced gastrointestinal cancers is known as “sandwich” therapy. Such a comprehensive treatment model can improve the surgical resection rate, reduce the local recurrence rate and distant metastasis rate, and also improve the postoperative survival rate, prolong the patient’s survival time and increase the cure rate. This treatment mode has become a routine treatment mode in the world famous cancer centers and “five major oncology hospitals” in China, especially for locally advanced rectal cancer, which is far better than the traditional surgery alone or direct surgery. 2. Clinical reality is often unsatisfactory, and many patients with locally advanced gastrointestinal cancer are eager to have surgery, with regrettable results. However, unfortunately, in the clinical practice of many primary hospitals, general hospitals and even some specialized hospitals, it is often found that some patients with esophageal cancer, gastric cancer or rectal cancer are diagnosed with cancer by gastroscopy or colonoscopy and then everything is done. On the one hand, patients’ family members are eager to treat and lack of medical knowledge, so they are hastily admitted to surgery to seek surgery opportunities, some of them do not do in-depth and systematic comprehensive examination, but simply do a chest X-ray, abdominal ultrasound and other examinations, and then rush to perform surgery. On the other hand, some surgeons have old concept, aging knowledge, lack of overall thinking and comprehensive treatment consciousness, take the scalpel in their hands as the “only gold standard” for tumor treatment, think that as long as they can remove the tumor, the patient can survive for a long time, and take the simple “removal” of the tumor as the same as “cutting”. “This is the same as “cutting out” the tumor. In this way, patients or family members are eager to operate, and doctors also want to operate. Under the influence of such dual factors, tragedies naturally occur, and the results of surgery can be imagined. Due to the late preoperative staging, the patient often has the following two possible tragic outcomes: (1) The tumor is found to have metastasized during the surgery, and the surgery cannot achieve clean resection, so a simple palliative surgery is done, and some even close the abdominal cavity directly. (2) The surgery can barely remove the tumor with the naked eye, but it is not easy to judge whether the tumor is clean or not, and the patient did not die on the operation table or during the perioperative period anyway, and the patient was treated with chemotherapy hastily after the surgery. This is not standardized, unscientific, lack of overall consideration and full management of the randomized treatment, in many primary hospitals, general hospitals and even some specialist hospitals is quite common, worrying.