Answer:
Palpable nodes with negative metastatic work up: Lymph node dissection.
For a single lung or liver met (Stage 4 disease): Systemic chemotherapy (dacarbazine, carmustine, and hydroxyurea), immunotherapy (BCG, melanoma vaccines), and radiation (skin nodules, LNs and cerebral mets may respond); used alone or in combination. On occasion surgical procedures may be indicated to reduce the tumor burden. Some adjuvant therapy is more effective as palliation of local symptoms.