Evolving management of metaplasia and dysplasia in Barrett's epithelium

Table 1 Vienna classification of Barrett’s oesophagus

1	Negative for dysplasia
2	Indefinite for dysplasia
3	Low-grade dysplasia
4a	High-grade dysplasia (including carcinoma in situ)
4b	Intra-mucosal carcinoma (including suspicious for invasive cancer)
5	Submucosal invasion by adenocarcinoma

Table 2 Different international management guidelines for Barrett's oesophagus

	BSG	FSDE	AGA	ACG	ASGE
No dysplasia	OGD every 3-5 yr for SSBO (< 3 cm), every 2-3 years FOR LSBO(> 3 cm)	OGD every 5 yr for SSBO (< 3 cm), every 3 yr for LSBO (3-6 cm), every 2 yr for LSBO (> 6 cm)	OGD every 3-5 yr	2 OGDs in the first year and then every 3 yr	No surveillance but if required should be every 3-5 yr
Low-grade dysplasia	Repeat OGD at 6 mo, if LGD offer endoscopic therapy	Repeat OGD if LGD perform OGD at 6 mo, 1 yr, then every year	OGD every 6-12 mo	Repeat OGD within 6 mo if no HGD then OGD every year	Repeat OGD within 6 mo if no HGD then OGD every year
High-grade dysplasia	Offer endoscopic therapy	Repeat OGD if HGD offer endoscopic/surgical therapy	OGD every 3 mo in the absence of endoscopic therapy	Repeat OGD within 3 mo, then every 3 mo or consider	Repeat OGD within 3 mo or endoscopic therapy
				Endoscopic therapy

BSG: British Society of Gastroenterology; FDSE: French Society of Digestive Endoscopy; AGA: American Gastroenterological Association; ACG: American College of Gastroenterology; ASGE: American Society For Gastrointestinal Endoscopy.