Publish date: 17 November 2023

New Soft Tissue Sarcoma Hub and Spoke services in London

***Please note that this diagnostic pathway does not apply to Bone Sarcoma. ALL suspected BONE Sarcomas must be referred to the Royal National Orthopaedic Hospital service ONLY***

A new diagnostic pathway has been developed for adult soft tissue sarcoma referrals in London. Services will be divided into ‘hubs’ (tertiary services providing treatment and clinical oversight) and ‘spokes’ (services delivering local diagnostics, from further imaging to pathology).

The Hubs are the Royal Marsden Hospital (RMH) and the London Sarcoma Service, which is a joint service between the Royal National Orthopaedic Hospital (RNOH) and University College London Hospitals (UCLH).

In west London, Spokes are currently located at Chelsea and Westminster NHS Foundation Trust (either the Chelsea or West Middlesex site), Croydon Health Services and Kingston Hospital.

In north central London, RNOH will continue act as a spoke for NCL until a new spoke is established.

In east London, a spoke will be established at Mile End Hospital.

In south east London, patients should be referred to the hub or spoke most convenient for the patient.

The London Sarcoma Service Hub, RMH Hub and all Spoke services are open to receive urgent suspected sarcoma cancer referrals from general practices in all London Integrated Care Systems.

Actions for referrers:

  • Adult patients with a mass that could be a soft tissue sarcoma based on clinical evaluation should be referred for a direct access urgent ultrasound.
  • Based on the ultrasound report and the clinical findings patients with:
  • A mass which could be a soft tissue sarcoma or another tumour (e.g. lymphoma) should be referred to one of the Spoke services for further evaluation, depending on the clinical picture and/or patient choice.
  • Masses which are highly suspicious of or confirmed as soft tissue sarcomas should be referred directly to one of the Hubs.

For further information, please contact