title: Aggressive treatment approach for cloacogenic carcinoma of the anorectum: report from a single cancer center.
abstract: OBJECTIVE
  The prognosis of cloacogenic carcinoma of the anorectum has rarely been investigated, and its clinical behavior is supposed to be similar to common squamous anal cancers. During the last 10 years, chemoradiation treatment (CRT) has been considered the standard of care for anal cancer.
  
  
  METHODS
  We retrospectively investigated the treatment of cloacogenic cancers treated within the framework of a multidisciplinary cancer center team during an 8-year period. The medical records of 7 patients affected by cloacogenic carcinoma were analyzed. Three patients presented distant metastases at the time of diagnosis. CRT using 5-fluorouracil + mitomycin or cisplatin was considered the gold standard for those cases amenable to cure.
  
  
  RESULTS
  After a mean follow-up time of 33 months (range 9-100), disease recurrence or progression was observed in 6 patients, which caused death in 3 of them. Three- and 5-year actuarial overall survival rates were 71 and 48%, respectively.
  
  
  CONCLUSIONS
  Our data seem to suggest that the cloacogenic origin could present prognostic relevance within the wide spectrum of anal cancers. This should be carefully considered when submitting patients to aggressive and prolonged treatments. However, this hypothesis needs to be confirmed by larger series of this disease.
authors.affiliation: Division of General and Laparoscopic Surgery, European Institute of Oncology, University of Milan, Milan, Italy. emilio.bertani@ieo.it
authors.forename: Emilio
authors.initials: E
authors.lastname: Bertani
authors.forename: Antonio
authors.initials: A
authors.lastname: Chiappa
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mazzarol
authors.forename: Gianmarco
authors.initials: G
authors.lastname: Contino
authors.forename: Roberta
authors.initials: R
authors.lastname: Lazzari
authors.forename: Maria Giulia
authors.initials: MG
authors.lastname: Zampino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Viale
authors.forename: Bruno
authors.initials: B
authors.lastname: Andreoni
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000601:surgery; D001005:Anus Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D001707:Biopsy, Needle; D002173:Cancer Care Facilities; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome