Siewert-Stein classification of esophageal adenocarcinoma

Dr Henry Knipe and Dr Roland Warner et al.

The Siewert-Stein classification of esophageal adenocarcinoma classes these tumors 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-esophageal junction (GEJ) tumors are a subset of oesophagal tumors 2


  • type I: adenocarcinoma of the distal esophagus (epicenter of lesion 1-5 cm above GEJ)
  • type II: adenocarcinoma of the cardia (epicenter of lesion up to 1cm above and 2cm below GEJ)
  • type III: sub-cardial type adenocarcinoma (epicenter of lesion 2-5cm below GEJ)

Type III generally have a worse prognosis 3.

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rID: 63972
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