Stage-Adapted Cryotherapy-Based Management of Oral Mucosal Melanoma: A Single-Center Retrospective Cohort

Background/Objectives: Oral mucosal melanoma (OMM) is a malignancy in which durable local control must be balanced against preservation of speech, swallowing, mastication, and oral structure. Although cryotherapy is a repeatable and function-preserving local modality, its role within contemporary multidisciplinary care has not been clearly defined. This study describes a stage-adapted cryotherapy-based management framework for primary OMM and evaluates survival, local recurrence, and prognostic factors in a contemporary single-center cohort. Methods: We retrospectively reviewed 43 patients with primary OMM treated between 2016 and 2026. Treatment allocation was non-randomized and made through multidisciplinary assessment: stage II-III patients received cryotherapy alone, whereas stage IV patients received cryotherapy combined with wide local excision; postoperative adjuvant therapy was considered individually. Overall survival (OS) was estimated using Kaplan-Meier methods, and prognostic factors were explored using univariable Cox regression. Results: Median follow-up was 35 months. Estimated 2-year and 5-year OS for the whole cohort were 93.0% and 69.8%, respectively. Local recurrence occurred in 2/11 stage II-III patients and 18/32 stage IV patients. Among stage IV patients, postoperative adjuvant therapy was associated with OS in an unadjusted exploratory comparison (p = 0.03); this association may be affected by confounding by indication and selection bias and should not be interpreted as a treatment effect. Nodal metastasis was associated with worse OS in univariable analysis (HR, 3.342; p = 0.036). Conclusions: This small, single-center, non-randomized cohort describes an institutional stage-adapted cryotherapy-based management framework for OMM. The findings do not establish comparative efficacy or objectively demonstrate functional preservation. Prospective multicenter studies with standardized treatment selection, complete treatment reporting, validated functional outcomes, and quality-of-life measures are required.