Efficacy and safety of cold forceps biopsy for diminutive pharyngeal neoplasms: Single‐center, prospective pilot study.

Background: Management of diminutive pharyngeal neoplasms is controversial. Thus, we conducted a single‐center, prospective pilot study to investigate the efficacy and safety of endoscopic excision with cold forceps biopsy (CFB) of these lesions. Patients and Methods: Thirty‐nine lesions endoscopically diagnosed with narrow‐band imaging as pharyngeal neoplasms of 3 mm or smaller were excised with CFB using jumbo biopsy forceps (cap diameter 2.8 mm, jaw volume 12.4 mm3). The primary outcome was endoscopically determined local remnant/recurrence rate 3 months after CFB. The secondary outcomes were histopathologically determined local remnant/recurrence rate; risk factors associated with the endoscopic remnant/recurrence; and incidence of intraoperative or delayed bleeding and other adverse events. Results: Histological diagnosis of the 39 CFB‐excised lesions were: 11 high‐grade dysplasia (28.2%), 22 low‐grade dysplasia (56.4%), two basal cell hyperplasia (5.1%) and four atypical squamous epithelium (10.3%).Twenty‐seven patients (30 lesions) underwent follow‐up endoscopy 3 months after CFB; the endoscopic and pathological local remnant/recurrence rate was 20% (6/30; 95% confidence interval (CI), 7.7–36.6%) and 16.7% (5/30; 95% CI, 5.6–34.7%), respectively. Location of the lesion in the hypopharynx was a significant risk factor associated with the endoscopic local remnant/recurrence (P = 0.049). No significant adverse events occurred. Conclusions: Cold forceps biopsy with jumbo biopsy forceps appears to be a safe and effective technique for excising diminutive pharyngeal neoplasms. Although small, the excised lesions may have a remarkably high frequency of high‐grade dysplasia. (Clinical trial registration number: UMIN000037980). [ABSTRACT FROM AUTHOR]