How do your adjuvant treatment recommendations change, if at all, for clinically node positive Stage III desmoplastic melanoma?

We will assume that the diagnosis has been confirmed by an expert pathologist and that surgically adequate local excision and lymphadenectomy have been performed.

One area in which adjuvant therapy of desmoplastic melanomas may differ is radiation of the primary. Local recurrence rates are considered by many to be higher than for other types of melanoma. In addition perineural invasion is more common; when this involves a named nerve one should at least consider radiation of the primary (Oliver, ...