الفهرس 
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Abstract
SUMMARYUMMARY UMMARY
ancer of Unknown Primary (CUP) is a heterogeneous group of metastatic cancers for which the primary site of origin at time of diagnosis after fulfilling routine diagnostic tools.
CUP make up 3–5% of total cancer diagnoses worldwide. In Egypt it is around 6.1%in males and 5.5% in females. CUP has mainly poor prognosis with aggressive behavior; its overall survival varies between (6–9 months) with an average of 7 months.
Several studies found that many factors were proved to impact the survival and treatment outcome including: age, gender, performance status, comorbidities, serum albumin level, serum alkaline phosphatase level, and smoking.
Searching the diagnosis is done through (full medical history and physical examination, laboratory tests, Radiological studies, Endoscopy, Biopsy) and treatment decision is made by cooperation of all of the multidisciplinary team (MDT) members which include: surgical oncologist, clinical oncologist, pathologist, radiologist, psychologists and nutritionists.
For adequate therapeutic management, the CUP should be classified into favorable or unfavorable subsets. According to ESMO guidelines 2015, it has to be tailored for each patient. Nearly (20%) of CUP patients of the favorable subsets
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managed similar to patients with equivalent known primary site. Patients included in this category have a good prognosis. But, unfavorable CUP patients (80%) have a poor prognosis and resistant to chemotherapy.
This retrospective study included 102 patients diagnosed with cancer of unknown primary. Patients were presented to Clinical oncology department at Ain Shams University Hospitals, and Helwan University Hospitals.
Patients’ records in the period from January 2012 to December 2017 were reviewed with follow up of treatment response, progression free survival and overall survival Data.
The aim in present study was to retrospectively identify the prognostic factors that influence treatment outcome and survival of patients diagnosed with cancer of unknown primary treated patients to help improving outcome and provide better practice.
In this study, some of the parameters addressed were found to be more or less similar to worldwide incidences with little variations. The median age at diagnosis was 63 years. With slight male predominance 62 (60.8%). The most common histological subtype in biopsied specimens was adenocarcinomas that represents (59.8%)