Siewert classification categorizes adenocarcinomas of the gastroesophageal junction. A tumor centered 3 cm above the anatomical cardia (Z-line) is classified as:

• A Siewert Type II
• B Siewert Type III
• C Siewert Type IV
• D Siewert Type I ✓

Explanation

The Siewert classification: Type I = adenocarcinoma of distal esophagus, epicenter 1–5 cm above the anatomical cardia (usually arises from Barrett's esophagus); Type II = true carcinoma of the cardia, epicenter within 1 cm above to 2 cm below the cardia; Type III = subcardial gastric carcinoma, epicenter 2–5 cm below the cardia. A tumor centered 3 cm above the Z-line = Type I. This classification determines surgical approach: Type I → esophagectomy; Type II → either transhiatal esophagectomy or extended total gastrectomy; Type III → total gastrectomy.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.