The esophagus plays an extremely important physiological function in human body, and esophageal cancer is a highly lethal disease among all the malignancies. Esophagectomy is still the main treatment for locally advanced esophageal cancer. Ensuring the efficacy of oncology plays a crucial role in exploring organ preservation in the treatment of esophageal cancer. We should always be aware of the inherent difficulties and potential harms of organ preservation for esophageal cancer treatment and seek a personalized and reasonable balance between ensuring cure and preserving organs, provide the best treatment design for esophageal cancer patients, to achieve maximum therapeutic effect without sacrificing the life quality of patients.

Non-small cell lung cancer (NSCLC) is an important malignancy. Surgery is the earliest treatment and still the main strategy for lung cancer at present. Recently, significant progress has been made in the diagnosis and treatment of lung cancer, covering new theories, knowledge, and methods that urgently require the attention and learning of surgeons. Only by following the new situation and strategies of oncology and making corresponding changes can surgical techniques be perfectly combined with the new developments in oncology, avoiding over-diagnosis/underdiagnosis and over-treatment/undertreatment of lung cancer, and ultimately creating new achievements for patients' long-term cure.

With the change of coronavirus disease 2019 (COVID-19) prevention and control strategy in China, the number of COVID-19 cases has increased significantly recently, which has also brought new challenges to the perioperative risk control of thoracic surgery. This paper puts forward several suggestions, aiming to standardize the preoperative screening and evaluation during the COVID-19 period, strictly grasp the indications and timing of surgery, optimize the medical management process, individualize surgical decision-making, and minimize the risk of COVID-19 infection to surgery.

Esophageal squamous cell carcinoma is one of the malignant tumors with a high incidence in China. The main pathological anatomy is the obstruction of the diseased esophagus. Nutritional disorders and a series of relevant pathophysiological changes are the main factors affec-ting the safe implementation of treatment and the long-term survival of patients. Therefore, timely correction of nutritional disorders is the main component of treatment. The ideal treatment for locally advanced esophageal squamous cell carcinoma is induction systemic treatment followed by surgery. The outstanding problems in clinical management of esophageal carcinoma are that only short-term attention is paid to postoperative nutrition support, ignoring preoperative nutrition along with the major anticancer treatment, the rehabilitation of patients' swallowing function after surgery, as well as nutrition and weight management. The author reviews the unique role of tube feeding with element enteral nutrition during the whole course of treatment of esophageal cancer, in order to provide reference for its standardized management.

With the change of COVID-19 prevention and control strategy in China, the number of COVID-19 cases has increased significantly recently, which has also brought new challenges to the perioperative risk control of thoracic surgery. This paper puts forward several suggestions, aiming to standardize the preoperative screening and evaluation during the COVID-19 period, strictly grasp the indications and timing of surgery, optimize the medical management process, individualize surgical decision-making, and minimize the risk of COVID-19 infection to surgery.

(1) Surgery is the first method to cure early stage non-small cell lung cancer (NSCLC). Ground glass nodule (GGO) like lung adenocarcinoma should be regarded as a new clinical issue to avoid over-treatment. The deep meaning of multidisciplinary pathological classification of lung adenocarcinoma should be fully understood to avoid over-diagnosis. The T staging of lung adenocarcinoma mixed with GGO components should be correctly understood to avoid over-staging. We should carefully understand the new data of relationship between sublobectomy and prognosis to avoid excessive resection. Attention should be paid to the research progress of minimal residual disease (MRD) to avoid insufficient treatment. (2) The treatment strategy of resectable stage Ⅲ NSCLC should be surgery with individualized systemic treatment. Locally advanced NSCLC dominated by Ⅲa-N2 NSCLC is a kind of disease with high multi-dimensional heterogeneity. In theory, preoperative treatment is superior to postoperative treatment, and molecular diagnosis should be made along with pretreatment staging, so as to select preoperative treatment. The patients with negative driver gene mutation obtained better pathological complete response/major pathological response (PCR/MPR) from immunotherapy compared to those from chemotherapy, and the better PCR/MPR is expected to be transformed into overall survival (OS). The data of preoperative treatment in patients with positive driver gene mutation are few, whereas the data of postoperative targeted treatment are much better than those of postoperative chemotherapy. (3) The effective systemic treatment strategy has "created" many long-term survivors with stage Ⅳ NSCLC, and has changed the original concept and population of "oligometastasis". Attention should be paid to the individual ineffective lesions in stage Ⅳ patients with long-term survival. It is also necessary to explore how to intervene in the resection of "oligometastasis" of stage Ⅳ NSCLC at an appropriate time and in an appropriate way, which may be one of the main tasks of lung cancer surgery in the future.

TNM system should be used in the staging of small cell lung cancer (SCLC), especially in the limited stages of SCLC. Preoperative staging should be strengthened to avoid invalid operation due to insufficient diagnosis. Retrospective studies showed that the efficacy of surgery (+ chemotherapy) in early SCLC is comparable to the outcome of resection for early stage non-small cell lung cancer, which shakes the concept of "chemotherapy/chemoradiotherapy as the main treatment of SCLC". The best operative procedure of SCLC is lobectomy. Sub-lobectomy and pneumonectomy are inferior to that of lobectomy, but still better than chemotherapy/chemo-radiotherapy in terms to long term survival. All these findings need to be confirmed by large sample prospective randomized studies.

Neoadjuvant therapy has become the first choice for locally advanced esophageal carcinoma. Patients with post-neoadjuvant positive lymph node staging (ypN+) have poor prognosis, and there is no effective adjuvant therapy. Programmed death protein-1 (PD-1) antibody can obtain better clinical efficacy in the treatment of advanced esophageal cancer. The authors designed a multicenter, prospective, randomized controlled clinical trial of Toripalimab (PD-1 antibody) adjuvant therapy on esophageal squamous cell carcinoma patients with ypN+ after the treatment of neoadjuvant chemotherapy combined with surgical resection, in order to provide clinical practices for the adjuvant treatment of ypN+ patients.

Since December 2019, a novel coronavirus (2019-nCoV, SARS-CoV-2) pneumonia (COVID-19) outbreak has occurred in Wuhan, Hubei Province, and the epidemic situation has continued to spread. Such cases have also been found in other parts of the country. The spread of the novel coronavirus pneumonia epidemic has brought great challenges to the clinical practice of thoracic surgery. Outpatient clinics need to strengthen the differential diagnosis of ground glass opacity and pulmonary plaque shadows. During the epidemic, surgical indications are strictly controlled, and selective surgery is postponed. Patients planning to undergo a limited period of surgery should be quarantined for 2 weeks and have a nucleic acid test when necessary before surgery. For patients who are planning to undergo emergency surgery, nucleic acid testing should be carried out before surgery, and three-level protection should be performed during surgery. Patients who are planning to undergo emergency surgery in the epidemic area should be confirmed with or without novel coronavirus pneumonia before operation, and perform nucleic acid test if necessary. Surgical disinfection and isolation measures should be strictly carried out. Among postoperative patients, cases with new coronavirus infection were actively investigated. For the rescue of patients with novel coronavirus infection, attention needs to be paid to prevention and treatment and related complications, including mechanical ventilation-related pneumothorax or mediastinal emphysema, and injury after tracheal intubation.

Thymic epithelial tumors are the most common tumors in anterior mediastinum. They are used to be considered rare in incidence, with an indolent nature of biological behaviors, which led to the lack of high level evidence obtained from prospective randomized controlled trials to guide the clinical treatment. At present, the experience of diagnosis and treatment of thymic tumors varies greatly in different regions. And there are still many problems remain to be solved. This paper aims to establish a standardized surgical treatment based on the latest researches in surgical indications, resection extent, surgical approach, lymph node dissection and postoperative management of thymic tumors.