In the Siewert classification of adenocarcinoma of the oesophagogastric junction (OGJ), a tumour centred within 1–5 cm above the OGJ (anatomical OGJ = z-line) is classified as:

• A Siewert Type II (true cardia carcinoma)
• B Siewert Type III (subcardial gastric carcinoma)
• C Siewert Type IV (antral carcinoma)
• D Siewert Type I (distal oesophageal adenocarcinoma) ✓

Explanation

Siewert classification: Type I = adenocarcinoma centred 1–5 cm above the OGJ (arising from Barrett's oesophagus, treated as oesophageal cancer — Ivor Lewis oesophagectomy); Type II = true cardia, centred 1 cm above to 2 cm below OGJ; Type III = subcardial, centred 2–5 cm below OGJ (treated as gastric cancer — total gastrectomy). Siewert type influences surgical approach and lymph node dissection template.

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

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Written and medically reviewed by the StethoPrep medical team.