Thoracic or General Surgery? Siewert’s staging of distal esophageal cancer and cardia cancer should belong to the same disease, that is, cancer of the esophagogastric junction (AEG), which refers to cancer with the center of the tumor located in the anatomical area of the cardia, 5 cm distally and proximally. It can be divided into three types: Type I: distal esophageal cancer, located 1-5 cm above the esophagogastric junction. Type II: cardia cancer, located in the upper 1cm to lower 2cm of the esophagogastric junction. Type III: subcardia carcinoma, located 2-5 cm below the esophagogastric junction. Siewert et al. found that compared to type II and III AEG patients, type I patients have the following characteristics: ① A large proportion of male patients. (ii) A greater tendency to have a history of hiatal hernia and gastroesophageal reflux. ③ Closer relationship with intestinal metaplasia, Barrett’s esophagus, etc. 80% of type I patients have intestinal metaplasia changes. ④The direction of type I lymphatic drainage upward can be to the mediastinum, to. For type II, III need open surgery, for type I need open thoracic surgery. If cross-regional then combined thoracoabdominal is preferred.