Table 1

The revised Vienna classification of gastrointestinal epithelial neoplasia

CategoryDiagnosisClinical 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.
1Negative for neoplasiaOptional follow up
2Indefinite for neoplasiaFollow up
3Mucosal low grade neoplasiaEndoscopic resection or follow up*
    Low grade adenoma
    Low grade dysplasia
4Mucosal high grade neoplasiaEndoscopic 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
5Submucosal invasion by carcinomaSurgical resection*