In what circumstances would you offer adjuvant radiation after resection of vulvar mucosal melanoma?

If immunotherapy is indicated, I would start that right away.

I would treat for positive margins or melanoma in situ at the margins using 30/5-6 fx twice a week. Would treat the tumor bed with a 10-15mm margin. I wouldn't treat the groins.

Would also recommend a thorough GYN exam in the OR if not d...

Only if positive margin after resection.