in 185 (54%) participants, which were ≥1 cm in 43 (13%). 14 (4.1%) participants underwent surgery for a suspect lesion (3 at baseline, 11 during follow-up). Pathological results in these patients revealed PDAC in 4 patients, low-grade precursor lesions in 7, a 5-mm neuroendocrine tumor in 1, autoimmune pancreatitis in 1, and no lesion in the resected specimen in 1. In total, 7 (2%) patients developed PDAC (median age 56 years, IQR 23). Two were diagnosed at baseline and underwent resection. Histology revealed a margin negative T2N1M0 and T1N0M0. Both patients died after 32 months. Another 5 individuals developed PDAC during follow-up, all of whom had prior abnormalities visible on both EUS and MRI (presumed side branch IPMN in 4, an indeterminate lesion in 2, a moderately dilated common bile duct in 1, and a main pancreatic duct stricture without visible mass in 1 case). Of the 5 PDACs detected at follow-up, 3 (60%) were irresectable (survival 1-4 months), two of which had presented as symptomatic interval carcinomas, of which one appeared to have arisen separately from the known side branch IPMN. One of the 5 underwent an irradical resection (T3N1M0, survival 18 months), and one was radically resected (T1N0M0, alive, 18 months after diagnosis). The overall median survival for the 6 deceased PDAC patients was 11 (IQR 30) months. CONCLUSION In this relatively young cohort of individuals at high risk for PDAC, timely identification of relevant resectable lesions proved challenging with surveillance based on imaging alone with EUS and MRI. The quantitative effect of surveillance on resectability rates and survival remain difficult to assess because of the limited number of cases and possible lead-time bias. Biomarkers may hold better promise to improve the outcome of surveillance in individuals at high risk for PDAC. Mo1375 CLINICAL COURSE AND RISK FACTORS OF PULMONARY EMBOLISM IN PATIENTS WITH PANCREATIC CANCER Ken Kurokawa, Nobuo Toda, Chikako Shibata, Junya Arai, Makoto Imai, Yukiyo Fukumura, Mayuko Kondo, Kaoru Takagi, Kentaro Kojima, Takamasa Ooki, Michiharu Seki, Jun Kato, Kazumi Tagawa Objectives: Pulmonary embolism (PE) sometimes occurs in patients with malignant neoplasm, particularly pancreatic cancer. However, the incidence, clinical course, and risk factors of this complication in patients with pancreatic cancer are not fully known. The aim of this study was to assess those issues on the basis of single-center experience in Japan. Methods: We retrospectively analyzed the consecutive patients with pancreatic cancer who were treated at Mitsui Memorial Hospital from January 2009 to December 2017. The diagnosis of PE was based on the contrast-enhanced computed tomography. The patients with PE following surgical procedures were excluded. The incidence and clinical course of PE were analyzed according to patient characteristics (age, sex, underlying conditions, and medication). More- over, multivariate regression model was applied to find the risk factors of PE. Results: Of total 303 patients with pancreatic cancer, PE was found in 27 patients (8.9%) (16 male, median age 68.7 years old, 3 in stage III and 20 in stage IV, and 19 with chemotherapy). PE was incidentally found in 22 patients (81.5%) without respiratory symptom, whereas only 5 (18.5%) showed symptoms including mild shortness of breath or chest tightness. Anticoagulant therapy was applied for 13 patients, and no exacerbation of PE was observed regardless of administration of anticoagulant therapy. Median survival time after the diagnosis of PE was 2.0 months (95% confidence interval (CI) 0.8-3.5). No significant differences were observed in median survival time between patients with and without symptoms, and between those with and without anticoagulant therapy. Multivariate analysis showed that poor performance status (odds ratio; 11.9, 95% CI 4.83-29.4) and the existence of distant metastases (odds ratio; 6.2, 95% CI 2.17-17.9) were independent risk factors of PE. Conclu- sions: PE was found in 8.9% of patients with pancreatic cancer, and most patients were asymptomatic. Their prognosis after the diagnosis of PE was poor. This study demonstrated that poor performance status and distant metastases were the significant risk factors. patient characteristics plumonary thromboembolism + - P-value n (%) 27(8.9) 276(91.1) sex (male/female), n 16(59.3)/11(40.7) 177(64.1)/99(35.9) 0.68 (%) age (mean ± SD) 68.7±11.7 72.2±10.3 0.07 BMI (mean ± SD) 20.6±3.5 21.5±3.5 0.28 eGFR (mean ± SD) 84.1±30.5 75.9±27.6 0.15 PT-INR (mean ± 1.28±0.26 1.20±0.28 0.20 SD) HbA1c (mean ± 6.8±1.5 6.9±1.8 0.64 SD) T-chol (mean ± SD) 175.6±46.0 190.8±55.5 0.27 performance status 0.2±0.4 0.1±0.3 0.13 (mean ± SD) 1(0.4)/10(3.6)/ 0(0)/0(0)/3(11.1)/ stage (0/IA/IB/IIA/ 12(4.3)/30(10.9)/ 0(0)/1(3.7)/3(11.1)/ 0.03 IIB/III/IV), n(%) 24(8.7)/71(25.7)/ 20(74.1) 126(45.7) 1st treatment (oper- 3(11.1)/16(59.3)/ 82(29.7)/112(40.6)/ ation/chemotherapy/ 0.07 8(29.6) 74(26.8) BSC), n(%) overall survival 13.8±16.9 14.0±15.0 0.93 (mean ± SD) risk factors S-757 AGA Abstracts univariate multivariate 95% confidence 95% confidence risk factors odds ratio P-value odds ratio P-value interval interval age 0.5 0.19-1.23 0.11 sex 0.81 0.34-2.02 0.68 body mass index 0.92 0.35-2.36 1.00 performance sta- 12.34 4.87-32.94 <0.01 11.9 4.83-29.4 <0.01 tus ≥ 2 distant metasta- 6.60 2.35-22.99 <0.01 6.2 2.17-17.9 <0.01 ses operation 0.34 0.05-1.49 0.13 chemotherapy 1.32 0.50-3.75 0.66 hypertension 0.72 0.28-1.74 0.54 diabetes mellitus 0.87 0.30-2.26 1.00 hyperlipidemia 0.45 0.11-1.38 0.18 smoking habit 1.09 0.45-2.60 0.84 Mo1376 FAMILIAL PANCREATIC CANCER PATIENTS HAVE BETTER SURVIVAL COMPARED SPORADIC PANCREATIC CANCER PATIENT Sushil Kumar Garg, Ayush Sharma, Dhruv P. Singh, Sajan Jiv Singh Nagpal, Harika Kandlakunta, Suresh T. Chari Introduction: Pancreatic cancer (PC) is currently the fourth leading cause of cancer-related death in the United States. While majority of PC are sporadic, 7% of patients report a family history of PC. Due to its rarity, the prognosis and survival of familial pancreatic cancer (FPC) (subjects with at least 2 FDRs with PC) is largely unknown. Methods: From the Mayo Clinic tumor registry we identified 236 subjects who met the following criteria: had biopsy proven pancreatic cancer and reported a family history of pancreatic cancer in a first degree relative. These patients were not a part of any surveillance program. We abstracted from medical records clinical, demographic, laboratory, radiology, surgery, pathology and vital status data. Patients' vital status information in the past 6 months was known in 95% of patients. In subjects undergoing resection of PC, we abstracted data on tumor volume, grade, and location. We compared this cohort of 236 patients to a recently described cohort of 225 patients with sporadic pancreatic cancer (SPC) patients (Gastroenterology 2018). Results: FPC subjects were younger at cancer diagnosis than SPC (66.5 (+/- 0.7 vs 72.2 (+/- 0.9, p 0.000); the proportion of males in the two groups was similar (51% vs 55%). The subset of FPC and SPC subjects without cancer-specific symptoms (abdominal/back pain, anorexia, fatigue) at diagnosis was similar (16% vs 12%). FPC patients were more likely to undergo PC resection compared to SPC (30.5% vs 20.4%, p=0.013). The mean volume of resected tumor in the two groups was similar (16.9 vs 14.8 cc). The proportion of resected tumors that was moderately differentiated was greater in FPC vs SPC (40% vs 26% p=0.1). In FPC group 53% patient received no treatment, 17.4% patient received surgery only, 12.3% chemotherapy only, 5% chemotherapy and surgery and 7.2 patient received radiation, chemotherapy and surgery. FPC had greater median survival than SPC (311 vs 186 days, p < 0.01). Cox-regression analysis showed resectabality was the biggest predictor of improved survival and age >70 was predictor of poor survival (Table 1). Conclusion: Patients with FPC have almost double the median survival compared to SPC, likely due to higher rate of resection despite similar presentation at diagnosis. Higher resection rate in FPC needs further study. Cox regression analysis for predcitors of mortality in familial pancreatic cancers patients Mo1377 THE CLINICOPATHOLOGIC CHARACTERISTICS OF MUCINOUS CYST NEOPLASMS SEPARATED BY AN EPITHELIAL LINING Hideki Shibata, Takeshi Aoki, Tomokazu Kusano, Tomotake Koizumi, Akira Fujimori, Yuta Enami, Masahiko Murakami, Nobuyuki Ohike Purpose: Mucinous cyst neoplasms (MCNs) that occur in the pancreas and liver are defined as cyst-forming epithelial neoplasms. They are usually composed of cuboidal or columnar, variably mucin-producing epithelium and are associated with ovarian-type subepithelial stroma. Owing to the risk of progression to invasive carcinoma, surgical resection is recom- mended for all surgically fit patients, but indolent MCNs are common. Methods: We investigated the pathological and genetic characteristics of MCNs categorized on the basis of the amount of mucin in the epithelial lining of 15 patients of MCN who had undergone a surgically resection between 1994 and 2016 at our institution. The patients were divided into 2 groups: (i) a rich (r)-MCN group, wherein more than half of the epithelium was lined by abundant mucinous epithelium (n = 6) and (ii) a poor (p)-MCN group, which consisted of the remaining cases (n = 9). Findings: No significant differences were noted between the two groups with respect to the patient's age, cyst size, or serum tumor markers (CEA, CA19-9). Two patients in the r-MCN group had invasive carcinoma forming the mural nodule, and 1 patient in the r-MCN group had high-grade dysplasia. The remaining patients in the r-MCN group and all patients in the p-MCN group had low-grade dysplasia. AGA Abstracts