On the basis of a prospective analysis of 107 adenocarcinomas of the gastro-esophageal junction we propose a differentiation into adenocarcinomas of Barrett's esophagus (endobrachyesophagus), "real" carcinoma of the cardia, and subcardial carcinoma of the fundus. This classification allows the determination of an adequate surgical resection. Therefore the operative risk can be kept low. Total esophagogastrectomy is reserved only for advanced "real" carcinomas of the cardia in this concept.