Is extranodal extension of pN1 NSCLC an indication to offer PORT?

All PORT analyses that I know show no benefit to XRT in N1 cases, and worse survival in some. The “extension” outside tempts one to alter these facts and treat. I would ask about systemic treatment. I’d reserve XRT for exclusive local relapse. I would offer PORT for + margin or any N2.

Dr. @Dr. First Last (the other Drew) has a valid point. Yet, I would treat this patient with a small-field technique to clean up the cancer cells that were left behind. This is b/c patients with N1 involvement and pathologically proven ENE aren't doomed to have a distant relapse. As such, PORT offer...