The revised Vienna classification of gastrointestinal epithelial neoplasia
| Category | Diagnosis | Clinical management |
|---|---|---|
| *Choice of treatment will depend on the overall size of the lesion; the depth of invasion as assessed endoscopically, radiologically, or ultrasonographically; and on general factors such as the patient's age and comorbid conditions. For gastric, oesophageal, and non-polypoid colorectal well and moderately differentiated carcinomas showing only minimal submucosal invasion (sm1) without lymphatic involvement, local resection is sufficient. Likewise, for polypoid colorectal carcinomas with deeper submucosal invasion in the stalk/base but without lymphatic or blood vessel invasion, complete local resection is considered adequate treatment. | ||
| 1 | Negative for neoplasia | Optional follow up |
| 2 | Indefinite for neoplasia | Follow up |
| 3 | Mucosal low grade neoplasia | Endoscopic resection or follow up* |
| Low grade adenoma | ||
| Low grade dysplasia | ||
| 4 | Mucosal high grade neoplasia | Endoscopic or surgical local resection* |
| 4.1 High grade adenoma/dysplasia | ||
| 4.2 Non-invasive carcinoma (carcinoma in situ) | ||
| 4.3 Suspicious for invasive carcinoma | ||
| 4.4 Intramucosal carcinoma | ||
| 5 | Submucosal invasion by carcinoma | Surgical resection* |