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Siewert Classification — SCE Medical Oncology MCQ

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ModerateGI CancersSiewert ClassificationSCE Medical Oncology

A 62-year-old man with gastric cancer has Siewert type II gastro-oesophageal junction (GOJ) adenocarcinoma. How does Siewert classification guide surgical approach?

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Correct answer: B — Siewert classifies GOJ adenocarcinoma by epicentre location

Siewert classification guides surgical approach for GOJ adenocarcinoma: Type I (distal oesophageal) → Ivor Lewis oesophagectomy; Type II (true cardia) → either oesophagectomy or extended total gastrectomy (institutional preference); Type III (subcardial gastric) → total gastrectomy with distal oesophageal resection. Perioperative chemotherapy follows the corresponding regimen (oesophageal or gastric protocols).

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer