e18252 Background: Studies have found higher risk of development of pulmonary embolism (PE) in those with metastatic disease within the first year of diagnosis, predominantly in pancreatic cancer. Therapeutic anticoagulation is consequently recommended in pancreatic cancer. We thus hypothesized that the rate of PE would be highest in pancreatic cancer compared to other solid tumors. Methods: We queried the Nationwide Inpatient Sample between 1999-2014 using the ICD-9 codes for PE in association with the following solid tumor types: esophageal, colorectal, lung, stomach, breast, pancreatic, liver and small intestine. The primary diagnosis was the type of solid tumor and the secondary diagnosis was PE. Chi-square analysis was used to to analyze for the independence of two variables. Results: From 1999-2014 there was a total of 16,473 cases of PE in solid tumors. 1.9% of the pancreatic cancer admissions developed a PE, followed by 1.7%, 0.9% and 0.8% for lung, liver, and colorectal, respectively (p > 0.05). Overall mortality rate for PE in pancreatic, lung, and colorectal cancers decreased from 32% in 1999 to 15% in 2014. Conclusions: Earlier detection due to improved diagnostic modalities may have contributed to the decrease in overall mortality rate observed in lung, liver, and colorectal cancers diagnosed with PE from 1999-2014. The highest rate of admissions associated with PE was seen in pancreatic cancer: however the differences between the four cancers were not statistically significant. Future studies should focus on observational prospective data monitoring solid malignancies for PE. If the prevalence of PE is indeed similar in different types of cancers, we should consider the addition of therapeutic anticoagulation to the current recommendations.
6618 Background: Molecular biomarkers have become essential in determining optimal treatment for patients with advanced non-small-cell-lung cancer (NSCLC). Few studies have evaluated the implementation of biomarker assessment (e.g. EGFR, ALK and ROS1) in routine clinical practice. We endeavored to assess adherence to biomarker testing guidelines in different clinical settings, specifically in a university hospital versus a community hospital in the same region. Methods: A retrospective analysis was conducted in newly diagnosed metastatic non-squamous-NSCLC patients comparing the compliance of biomarker testing based on nationally established guidelines available at the time of diagnosis. De-identified electronic health record (EHR) data were collected from Mercy Catholic Medical Center (MCMC) and Hahnemann University Hospital (HUH) between 1/1/15- 1/30/19. Results were compared in each setting to determine utilization of biomarker testing. Results: 27 patients were identified at MCMC and 41 at HUH. 22 (81%) patients at MCMC and 36 (88%) patients at HUH underwent appropriate molecular testing based on guidelines available at the time of diagnosis. Conclusions: Our data suggests that both university and community institutions have appropriately adapted the evolving guidelines for molecular testing for patients with non-squamous NSCLC. In the rare instances that molecular testing was not performed, the most common reason was inadequate amounts of tissue available. Newer technologies, such as next-gen sequencing and serum based testing, will make compliance with guidelines easier in the future, particularly as increasing numbers of molecular markers will need to be assessed.
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