Huey RW, Makawita S, Xiao L, et al. - Researchers intended to generate data on clinicopathological profile and management of sarcomatoid carcinoma of unknown primary (SCUP). Via a retrospective review of the MD Anderson Cancer of Unknown Primary database and tumor registry, they selected 48 SCUP patients from 2001 to 2017. The median age at diagnosis was 59 years. For the entire cohort, the median overall survival (OS) was estimated to be 11 months (95% CI: 5.6 to 16.4). The factors that showed a significant link with worse OS were poor performance status (PS), > 1 metastatic site, elevated lactate dehydrogenase, and high neutrophil-to-lymphocyte ratio (NLR), as revealed in univariate analyses. Multivariate analyses revealed poor PS and high NLR as independent prognostic factors for OS. The rare occurrence of SCUP was reported. This disease entity was shown to run an aggressive clinical course and carried limited survival. Making its diagnosis was difficult and careful review and synthesis of histology, immunohistochemistry, and molecular diagnostics were needed for making a diagnosis. Chemotherapy resistance continued to be a challenge. It is justified to perform early mutational profiling. For this subset, clinical trial participation should be encouraged.