Adenocarcinoma stage 4 prognosis, what to do?

Define primary: Definite treatment indicated. The primary site of the adenocarcinoma must be defined and resected if possible. Then what has metastasized will only remain at that site but with the tendency to grow. With the primary removed, the metastatic site can be approached, by radiation, chemo, immunotherapy. When primary removed, chemosensitization studies can be performed to choose best drug.