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01.01.2012 | Original Article | Ausgabe 1/2012

Virchows Archiv 1/2012

Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED)

Virchows Archiv > Ausgabe 1/2012
M. Dinis-Ribeiro, M. Areia, A. C. de Vries, R. Marcos-Pinto, M. Monteiro-Soares, A. O’Connor, C. Pereira, P. Pimentel-Nunes, R. Correia, A. Ensari, J. M. Dumonceau, J. C. Machado, G. Macedo, P. Malfertheiner, T. Matysiak-Budnik, F. Megraud, K. Miki, C. O’Morain, R. M. Peek, T. Ponchon, A. Ristimaki, B. Rembacken, F. Carneiro, E. J. Kuipers, on behalf of MAPS Participants
Wichtige Hinweise
MAPS Participants include: Cathomas G (Switzerland), Fedorov ED (Russia), Figueiredo P (Portugal), Goldis A (Romania), Leja M (Latvia), Moehler M (Germany), Plesea E (Romania), Bergman J (the Netherlands), Hamoudi W (Jordan), Almeida R, Annibale B, Lobo LA, Balaban YH, Boeriu A, Burette A, Mallet AC, David L, Delchier J-C, Dobru ED, Fernandes C, Kahaleh M, Kashin S, Lomba-Viana R, Lunet N, Marakhouski K, Moreira-Dias L, Ferreira CF, Pais TP, Rollán A, Sadio A, Santos C, Chu K-M, D’Ambra G, Ellul P, van Grieken N, Lamarque D, Najeeb AA
These guidelines represent a consensus of best practice based on the available evidence at the time of preparation. They may not apply in all situations and should be interpreted in the light of specific clinical situations and resource availability. Further controlled clinical studies may be needed to clarify aspects of these statements, and revision may be necessary as new data appear. Clinical consideration may justify a course of action at variance to these recommendations. These guidelines are intended to be an educational device to provide information that may assist endoscopists in providing care to patients. They are not rules and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment.


Atrophic gastritis, intestinal metaplasia, and epithelial dysplasia of the stomach are common and are associated with an increased risk for gastric cancer. In the absence of guidelines, there is wide disparity in the management of patients with these premalignant conditions. The European Society of Gastrointestinal Endoscopy, the European Helicobacter Study Group, the European Society of Pathology, and the Sociedade Portuguesa de Endoscopia Digestiva have therefore combined efforts to develop evidence-based guidelines on the management of patients with precancerous conditions and lesions of the stomach. A multidisciplinary group of 63 experts from 24 countries developed these recommendations by means of repeat online voting and a meeting in June 2011 in Porto, Portugal. The recommendations emphasize the increased cancer risk in patients with gastric atrophy and metaplasia and the need for adequate staging in the case of high-grade dysplasia, and they focus on treatment and surveillance indications and methods.

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