Siewert-Stein classification of oesophageal adenocarcinoma
The Siewert-Stein classification of oesophageal adenocarcinoma classes these tumours according to their relationship to anatomical landmarks 1. It was initially proposed by Siewert et al in 1996, becoming widely used in predicting lymph node spread and directing optimal management. As of the 7th edition of the TNM classification system, gastro-oesophageal junction (GOJ) tumours are a subset of oesophagal tumours 2.
- type I: adenocarcinoma of the distal oesophagus (epicenter of lesion 1-5 cm above GOJ)
- type II: adenocarcinoma of the cardia (epicenter of lesion up to 1cm above and 2cm below GOJ)
- type III: sub-cardial type adenocarcinoma (epicenter of lesion 2-5cm below GOJ)
Type III generally have a worse prognosis 3.
- 1. Siewert JR, Stein HJ. Carcinoma of the cardia: carcinoma of the gastroesophageal junction—classification, pathology and extent of resection. Dis Esophagus 1996;9:173-82.
- 2. Sobin L, Gospodarowicz M, Wittekind C: TNM classification of malignant tumors. 7th edition. Oxford: Wiley-Blackwell; 2009
- 3. Curtis NJ, Noble F, Bailey IS, Kelly JJ, Byrne JP, Underwood TJ. The relevance of the Siewert classification in the era of multimodal therapy for adenocarcinoma of the gastro-oesophageal junction. J Surg Oncol. 2013;109(3):202-7. doi 10.1002/jso.23484