How would you manage recurrent popliteal and inguinal LNs from melanoma?

1. Confirm no distant metastases.

2. Therapeutic lymphadenectomy if possible, followed by adjuvant lymph node basin radiotherapy, 48 Gy/20 fractions or equivalent in 2 Gy fractions. If BRAF altered, consider adjuvant dabrafenib/trametinib. If not BRAF altered, consider adjuvant ipilimumab.

3. If unr...