Questions around removal of the primary in metastatic treatment

This is so helpful thank you for responding and yes I would love any links you can share. My understanding too is that the survival data is so old (10-15 years) that clinical decisions such as this take a VERY skilled practitioner to take into account the age of stats, new treatments and many doctors are very head in the data and linear decision makers. Its such a challenge to be a better thinker than your dr