Worldwide, Total Mesorectal Excision (TME) has become the gold standard treatment for middle and lower rectal cancer. Studies have demonstrated a TME improves local recurrence rates and the corresponding survival by as much as 20%. High-quality TME surgery reduces local recurrence from 20% to 30% and increases 5-year survival from 48% to 68%.
The June 2022 CTR Coding Break titled ‘STORE Manual 2022 Macroscopic Mesorectum’ discusses the definitions and details of a Total Mesorectal Excision (TME) and the newly implemented data field, Macroscopic Mesorectum. This data item records whether a TME was performed and the macroscopic evaluation of the completeness of the excision. Macroscopic Mesorectum is collected on all abstracted rectal topography code C20.9 after v22 implementation date, regardless of date of diagnosis. This data item is left blank for all sites other than C20.9. Information about this field should come from the pathology report synopsis report only or from a physician’s statement of a TME having been performed and the pathology outcome.