Effectiveness and Mechanism of Cryoablation in the Treatment of Oral Mucosal Melanoma.

OBJECTIVES: To assess the effectiveness and safety of cryoablation for oral mucosal melanoma (OMM) and explore its underlying mechanisms to provide insights for precision treatment of OMM. MATERIALS AND METHODS: Patients diagnosed with OMM were divided into a cryoablation group and a noncryoablation therapy group. We compared the therapeutic outcomes of these groups and investigated the effects of cryoablation on glycometabolism, the immune microenvironment, and cell death modalities in the OMM. RESULTS: The study included 32 OMM patients, with 18 in the cryoablation group and 14 in the noncryoablation therapy group. Cryoablation demonstrated high safety and effectiveness, with a postoperative survival rate of 72.22% (13/18). The median overall survival was 85.5 months (95% CI: 57.3-113.6) in the cryoablation group and 72.4 months (95% CI: 51.36-93.4) in the non-cryoablation group. Significant changes in the immune microenvironment, including increased infiltration of CD4+, CD8+, and CD66+ cells and elevated expression of PD-1, PD-L1+, and CTLA4+ immune checkpoints, were observed postcryoablation. Conversely, FOXP3+ and CD19+ cell densities significantly decreased. Additionally, the expression levels of GLUT-1, HIF-1α, and PK-M2 were notably reduced. The primary antitumor effect of cryoablation is attributed to apoptosis. CONCLUSION: Cryoablation is an effective treatment for OMM, and its antitumor effects are potentially linked to the modulation of the immune microenvironment, alteration of glucose metabolism, and induction of apoptosis.