Rectal cancer: An evidence-based update for primary care providers

Table 3 Vocabulary for the treatment of rectal cancer

Anterior resection	Resection of rectum with an anastomosis above the pelvic peritoneal reflection
Low anterior resection	Resection of rectum with an anastomosis below the pelvic peritoneal reflection
TME	Total mesorectal resection. The adipose tissue at the posterior and lateral aspects of the rectum which contains the draining lymph nodes, is dissected down to the pelvic floor and resected
PME	Partial mesorectal excision. The mesorectum is divided 5 cm below the cancer as well as the distal rectum. PME is performed for cancers located in the upper rectum and rectosigmoid junction
TEM	Transanal endoscopic microsurgery. A specially designed proctoscope with an attached microscope permits local resection of premalignant lesions and selected cases of early rectal cancer up to 20 cm from the anal verge
TAE	Transanal excision. Lesions in the lower third of rectum can be resected transanally
APR	Abdominoperineal resection. Low rectal cancers that cannot be resected with a sphincter-saving procedure are resected with perianal tissue and the anal canal en bloc with the whole rectum and mesorectum
Adjuvant	Additional treatment (chemotherapy, radiation therapy or chemoradiation) given after surgical resection
Neoadjuvant	Preoperative treatment
CRT	Chemoradiotherapy. Chemotherapy drugs typically involve 5-fluorouracil, leucovorin and oxaliplatin. These are given in order to increase cancer cells sensitivity to the radiation. CRT is frequently offered to patients preoperatively (neoadjuvant) in order to reduce local recurrence but has not shown to improve overall survival
Intersphincteric resection	The internal anal sphincter muscle is resected in continuity with the lower rectum preserving the external anal sphincter in order to preserve anal function and avoid colostomy in cases of ultralow rectal cancer
CRM	Circumferential resection margin is the distance in mm from the mesorectal fascia (the resection plane) to the nearest tumor growth
DRM	Distal resection margin

TME: Total mesorectal excision; CRT: Chemoradiotherapy; TAE: Transanal excision; TEM: Transanal endoscopic microsurgery.