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The ninth edition of TNM staging for lung cancer has been announced at the 2023 World Lung Cancer Congress and implemented from January 1, 2024. The focus of the ninth TNM staging change is dividing N2 into N2a and N2b, as well as M1c into M1c1 and M1c2. Although the T staging has not changed, it has played an important role in verifying the eighth edition of the T staging. The subdivision of stage N2 has led some patients with ⅢA of the eighth edition to experience ascending or descending stages, which will more accurately help to assess the condition and prognosis of patients with mediastinal lymph node metastasis, as well as the design of related clinical studies. Modifying the M1c staging will help define oligometastasis and explore new treatment models in the future. The ninth edition of the TNM staging system provides a more detailed division of different tumor loads, but there is no clear explanation for the staging of lung cancer after neoadjuvant therapy. Further data analysis is needed, and it is expected to be answered in the tenth edition of TNM staging.

The efficacy of surgery alone for locally advanced esophageal cancer is poor, which requires the active participation of multimodality treatment. Neoadjuvant therapy, especially neoadjuvant chemoradiotherapy, could significantly lead to tumor downstage, bring higher radical resection rate and improve the prognosis. The NEOCRTEC5010 trial, a multicenter prospective randomized controlled trial on neoadjuvant chemoradiotherapy for locally advanced esophageal squamous cell carcinoma has provided sufficient and valuable evidence for us, especially for some key questions after neoadjuvant chemoradiotherapy, such as perioperative complications, value of systemic lymphadenectomy, the post-operation recurrence pattern, pathological complete response, long-term prognosis and survival. In addition, the current development of tumor immunotherapy is so rapid that the role of immunotherapy in the first line treatment of advanced or relapsed/metastatic esophageal cancer has been confirmed. In the near future, neoadjuvant therapy based on immunnology-led combined with traditional chemoradiotherapy or chemotherapy is expected to become a new theraputic strategy to further improve the treatment efficacy of locally advanced esophageal squamous cell carcinoma. This paper focused on the classical research of neoadjuvant therapy for locally advanced esophageal squamous cell carcinoma and the development of immunotherapy for esophageal cancer, aiming to improve the understanding of neoadjuvant therapy for locally advanced esophageal squamous cell carcinoma. This will help to carry out optimal clinical work and to design better clinical study.

Minimally invasive surgery helps enhance postoperative recovery and improve quality of life of the patients by minimizing surgical trauma and decreasing incisional pain. Minimally invasive pulmonary resection, including both video-assisted thoracoscopic surgery and robotic surgery, is mainly used for surgical management of peripheral early stage lung cancers. Because of tumor location, lymph node involvement, and treatment modalities, surgery for central lung cancers is often technically demanding. Open thoracotomy is still the dominant approach for these tumors, especially when complex procedures such as sleeve lobectomy or pneumonectomy are needed. With the advent of surgical techniques, minimally invasive techniques have started to be tried in treatment of central lung cancers. Initial results have proven their feasibility and safety in sleeve lobectomy and pneumonectomy, showing a great potential of minimally invasive surgery in the future. Further study is necessary to prove its functionally superiority and oncological equivalence to open surgery, so that more lung cancer patients could benefit for minimally invasive surgery.

With the emergence of new concepts and new technologies, the mode of diagnosis and treatment of thoracic surgery in China has changed greatly. Under this background, Chinese thoracic surgery ushered in its "golden age" . This paper expounds the new challenges of thoracic surgery in China from many aspects, and points out that with the advent of precision medicine and modern science and technology, thoracic surgery will continue to develop rapidly. We should seize the opportunity, further expand our advantages, and strive to create a new era of Chinese thoracic surgery.