How do you approach treatment for a patient who develops a nodal recurrence years after primary resection of NSCLC?   

I agree with @Percy Lee's approach re mediastinal relapse; we consider delayed limited nodal relapse as a manifestation of microscopic disease that has had the opportunity to manifest itself, and the implication would be that this was Stage III disease to begin with, and our salvage strategy therefo...

I assume that when you say nodal recurrence, you are referring to mediastinal nodal recurrence. In these situations, whether it is after surgery or SBRT to the primary, I would treat this patient as a de novo or recurrent stage III patient. If the patient is medically fit, then neoadjuvant therapy (...