Background: The POLST “Practitioner Orders for Life-Sustaining Treatments” form addresses patient goals, scope of therapies, artificial nutrition, and resuscitation status. In New Jersey, Section A offers a unique opportunity for patients to describe in their own words overall goals of care. We investigated if completion of Section A influences aggressiveness of care at end of life for patients with advanced cancer syndromes. Methods: All POLST forms completed in 2015 at the University Medical Center of Princeton were retrospectively reviewed. Patients 18 years or older, electing for DNAR/DNAI status, were eligible for inclusion. All other responses on the POLST form were collected. Chart review was used to collect admitting diagnosis, referral and/or admission to the intensive care unit, palliative care and hospice use, length of stay, number of readmissions and deaths in the hospital. Discharge summaries were reviewed to assess if advance care planning discussions were documented. Results: 57 charts were reviewed: 34% were female, age 41 to 99 (mean 82), and average LOS was 6 days. 19% preferred “symptom treatment only” on their POLST forms and 70% preferred “limited treatment.” Section A was completed for 34 of 57 patients (60%). Those completing section A were less likely to be referred to the ICU, had a shorten length of stay (5 vs. 9 days), and had fewer unexpected deaths in the hospital. In addition, those completing section A were more likely to utilize both palliative and hospices services. Though physicians rarely documented code status on discharge summaries (38%), all patients with a palliative care consult while hospitalized had advance care planning discussions documented at discharge. Conclusions: Use of the POLST form provides a very natural order for discussion of life sustaining treatments and end-of-life care. Patients completing section A were more likely to utilize palliative care, hospice services, and advance care planning. The benefits of the POLST form extends beyond patient outcomes and may positively impact the care patients with advanced cancer syndromes. The importance of individualized preferences seems logical, but larger studies are needed to validate our findings.