[Interpretation of expert consensus on primary tumor management for metastatic colorectal cancer (2026 edition)].

The recently released Expert Consensus on the Management of Primary Tumor in Metastatic Colorectal Cancer (2026 Edition) represents a systematic update and paradigm shift in the management of the primary tumor, developed against the backdrop of significant advances in systemic therapy for metastatic colorectal cancer (mCRC) and the accumulation of high-quality clinical evidence. This consensus breaks from the traditional notion of prophylactic primary tumor resection (PTR) and establishes "systemic therapy first" as the fundamental principle. Based on a multidisciplinary team (MDT) model, it provides refined stratification regarding the indications, contraindications, timing, technique selection, and perioperative management of PTR. This article interprets the background, evolution of core concepts, clinical decision-making logic, distinctive technical concepts, and future research directions outlined in the consensus, aiming to assist clinicians in accurately understanding its implications and to promote standardized and individualized management of the primary tumor in mCRC.