What is your approach for locoregional mediastinal recurrence of NSCLC adenocarcinoma in fit patients >5 years from definitive treatment (chemoradiation and/or surgery)?

There are a lot of variables here including number of lymph node stations involved, bulky vs non bulky disease, and lung/cardiac function. I would treat this similar to de novo diagnosis given the timeframe from prior treatment as this is unlikely to be an isolated relapse this far out. Definitive c...

I would consider this a late relapse if same histology. Given the prior radiation therapy, I would think toxicity would be great from radiation.

I would treat this as recurrent disease, and depending on histology and PDL1 status use immunotherapy +/- chemotherapy unless adenocarcinoma PDL- in which ...