After esophageal cancer, gastric cancer and rectal cancer are diagnosed, it is important not to rush to surgery! Scientific and systematic evaluation and correct staging before surgery are very important. Remember: qualitative diagnosis is important, staging diagnosis is more important. Many patients with esophageal, gastric and rectal cancers are found to have obvious lymph node metastasis after chest, upper abdomen enhanced CT and pelvis enhanced CT or magnetic resonance, ultrasound endoscopy and other examinations. How to treat these patients scientifically? Is it immediate surgery? The answer is no. According to the latest international research progress, patients with locally advanced esophageal, gastric and rectal cancers with lymph node metastasis should be treated with chemotherapy or/and radiotherapy before surgery, followed by radical surgery, and then appropriate chemotherapy should be given after the surgery, which is the best treatment mode. This method of treating locally advanced gastrointestinal cancer is figuratively called “sandwich” therapy. Such a comprehensive treatment mode can not only improve the surgical resection rate, reduce the local recurrence rate and distant metastasis rate, but also improve the survival rate of patients after surgery, prolong the survival time of patients and increase the cure rate. This treatment mode has become a routine treatment mode in the world-renowned oncology centers and “five major specialized oncology hospitals” (Cancer Hospital of the Academy of Medical Sciences, Beijing Cancer Hospital, Shanghai Cancer Hospital, Sun Yat-sen University Cancer Hospital, Tianjin Cancer Hospital) in our country, especially the effect of locally advanced rectal cancer, which is far better than the traditional simple surgery or direct surgery. The effect is good. However, unfortunately, in the clinical practice of many grassroots hospitals, general hospitals and even some specialized hospitals, it is often found that some patients with esophageal cancer, gastric cancer or rectal cancer have nothing to do after being diagnosed with cancer by gastroscopy or colonoscopy. On the one hand, patients’ family members are eager for treatment and lack of medical knowledge, so they hastily check into the surgical department to seek for surgical opportunities, and some of them do not do in-depth systematic and comprehensive examination, but simply do a chest X-ray, abdominal ultrasound, etc., and then rush to have the surgery. On the other hand, some surgeons have outdated concepts, aging knowledge, lack of holistic thinking and awareness of comprehensive treatment, and take the scalpel in their hands as the “only gold standard” for treating tumors, believing that as long as they can remove the tumor, the patients can survive for a long time, and equate simple “removal” of a tumor with “surgery” of a tumor. They think that as long as they can remove the tumor, the patient will be able to survive for a long time, and equate the simple “resection” of the tumor with the “cutting clean” of the tumor. In this way, patients or their families are eager to operate, and doctors also want to operate. Under the influence of these two factors, tragedy naturally unfolds, and the outcome of the operation can be imagined. Due to the late preoperative staging, patients often have the following two possible tragic outcomes: 1, intraoperative exploration found that the tumor has metastasized, the operation could not achieve clean resection, simply do a palliative surgery, and some even directly close the abdominal cavity. 2, the operation was barely able to do the visual resection, and it is not easy to judge whether the resection is clean or not, and the patient didn’t die on the operating table or during the perioperative period, and then the patient was treated with chemotherapy after the operation. After surgery, the patient soon relapsed and metastasized, and was transferred to internal medicine for treatment. Such non-standardized, unscientific, randomized treatment that lacks overall consideration and full management is quite common in many grassroots hospitals, general hospitals and even some specialized hospitals, which is worrying.