Stage 4 pancreatic cancer, also called metastatic pancreatic cancer, occurs when cancer cells spread beyond the pancreas to distant organs including the liver, lungs, or peritoneum, requiring comprehensive treatment strategies that balance life extension with quality of life preservation. TL;DR Only 15-20% of pancreatic cancers are diagnosed at potentially resectable stages, with most patients presenting with stage 4 disease requiring systemic therapy [1] FOLFIRINOX achieved