Would you treat a patient with an N2 ipsilateral recurrence following re-resection of bronchial stump recurrence?

My answer is predicated on the assumption that this patient has not had prior radiation therapy. If that is the case, then I would treat them. It is important to talk to the thoracic surgeon and know how the bronchial stump was "finished". My preference is that it is done with a fresh intercostal muscle flap to reduce the risk of a dehiscence or blowout after treatment. In this case, I'd treat the bronchial stump, hilar LNs, involved N2 station, and next LN station on either side of the involved station with chemo/RT (60 Gy in 30 fxns) → consolidation durvalumab (unless they have an EGFR mutation, then I'd use osimertinib as consolidation). Hope that is helpful.

Yes. Dr. @Dr. First Last and I first published the MGH experience decades ago. Five of 8 bronchial stump recurrences did very well with radical XRT: Kopelson and Choi, PMID 6257628. President Reagan was just elected!