{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T12:14:31Z","timestamp":1773404071617,"version":"3.50.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2021,2,22]],"date-time":"2021-02-22T00:00:00Z","timestamp":1613952000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,2,22]],"date-time":"2021-02-22T00:00:00Z","timestamp":1613952000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Gastric Cancer"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Guidelines recommend endoscopy with biopsies to stratify patients with gastric premalignant lesions (GPL) to high and low progression risk. High-risk patients are recommended to undergo surveillance. We aimed to assess the accuracy of guideline recommendations to identify low-risk patients, who can safely be discharged from surveillance.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This study includes patients with GPL. Patients underwent at least two endoscopies with an interval of 1\u20136\u00a0years. Patients were defined \u2018low risk\u2019 if they fulfilled requirements for discharge, and \u2018high risk\u2019 if they fulfilled requirements for surveillance, according to European guidelines (MAPS-2012, updated MAPS-2019, BSG). Patients defined \u2018low risk\u2019 with progression of disease during follow-up (FU) were considered \u2018misclassified\u2019 as low risk.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>334 patients (median age 60\u00a0years IQR11; 48.7% male) were included and followed for a median of 48\u00a0months. At baseline, 181\/334 (54%) patients were defined low risk. Of these, 32.6% were \u2018misclassified\u2019, showing progression of disease during FU. If MAPS-2019 were followed, 169\/334 (51%) patients were defined low risk, of which 32.5% were \u2018misclassified\u2019. If BSG were followed, 174\/334 (51%) patients were defined low risk, of which 32.2% were \u2018misclassified\u2019. Seven patients developed gastric cancer (GC) or dysplasia, four patients were \u2018misclassified\u2019 based on MAPS-2012 and three on MAPS-2019 and BSG. By performing one additional endoscopy 72.9% (95% CI 62.4\u201383.3) of high-risk patients and all patients who developed GC or dysplasia were identified.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>One-third of patients that would have been discharged from GC surveillance, appeared to be \u2018misclassified\u2019 as low risk. One additional endoscopy will reduce this risk by 70%.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10120-020-01149-2","type":"journal-article","created":{"date-parts":[[2021,2,22]],"date-time":"2021-02-22T16:03:26Z","timestamp":1614009806000},"page":"680-690","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Accuracy of upper endoscopies with random biopsies to identify patients with gastric premalignant lesions who can safely be exempt from surveillance"],"prefix":"10.1007","volume":"24","author":[{"given":"Michiel C.","family":"Mommersteeg","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stella A. 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SAVN declares that she has no conflict of interest. WJH declares that he has no conflict of interest. LH declares that she has no conflict of interest. CMH declares that she has no conflict of interest. LGC declares that she has no conflict of interest. TJT declares that he has no conflict of interest. MPA declares that she has no conflict of interest. IPB declares that she has no conflict of interest. EMW declares that she has no conflict of interest. FTB declares that he has no conflict of interest. JPWB declares that he has no conflict of interest. MD declares that he has no conflict of interest. MJB has received research grants from from Boston Scientific, grants and personal fees from Cook Medical, grants from Pentax Medical, grants from 3M, grants from Mylan, grants from InterScope, outside the submitted work;. MPP declares that he has no conflict of interest. GMF declares that she has no conflict of interest. EJK declares that he has no conflict of interest. MCWS declares that she has no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}