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Efficacy and safety of cold forceps biopsy for diminutive pharyngeal neoplasms: Single‐center, prospective pilot study
Author(s) -
Shimodate Yuichi,
Itakura Junya,
Sunami Tomohiko,
Ueno Masayuki,
Ishikawa Sho,
Hira Daichi,
Takayama Hiroshi,
Sumiya Tomoki,
Sue Masahiko,
Takezawa Rio,
Doi Akira,
Nishimura Naoyuki,
Mouri Hirokazu,
Matsueda Kazuhiro,
Yamamoto Hiroshi,
Mizuno Motowo
Publication year - 2021
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.13838
Subject(s) - medicine , biopsy , dysplasia , forceps , prospective cohort study , surgery , endoscopy , single center , confidence interval , radiology
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 mm 3 ). 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).