Soft Tissue Sarcoma 2ww Care Pathway

Review in progress

Disclaimer: The guidance contains helpful primary care information for management of referrals and up to date referral criteria. These guidelines are locality specific to best reflect local services. This guidance does not override or replace the individual responsibility of healthcare and social care professionals involved in the delivery of care to make informed professional judgements appropriate to the circumstances of the individual.

Scope

REFERRAL GUIDELINES FOR SUSPECTED SOFT TISSUE SARCOMA CANCER (All patients will be seen within 2 weeks of referral)

  • Refer a patient who presents with symptoms suggesting soft tissue sarcoma as detailed in the NICE guidance below. If you have concerns about a patient's symptoms and /or signs, consider a discussion with the local specialist.
  • Only refer when patient is available to attend an appointment within the next 14 days.

Assessment

Referral

Referral Criteria

Urgent referral:

  • A patient presents with a palpable lump that is:
    • greater than about 5cm in diameter
    • deep to fascia, fixed or immobile
    • increasing in size
    • painful
    • a recurrence after previous excision
  • If a patient has HIV, consider Kaposi's sarcoma and make an urgent referral if suspected

2WW referral for adults with:

  • Ultrasound scan findings suggestive of soft tissue sarcoma, or
  • Ultrasound scan findings that are uncertain and clinical concern persists
  • In children and young people this should be within 48 hours.

Consider urgent ultrasound scan (within 2 weeks) adults with:

  • Unexplained lump which is increasing in size
  • In children and young people this should be within 48 hours

Urgent Investigation:

  • Urgently investigate increasing, unexplained or persistent bone pain or tenderness, particularly pain at rest (and especially if not in the joint), or an unexplained limp. In older people metastases, myeloma or lymphoma, as well as sarcoma, should be considered.

PLEASE NOTE:

  • The Mid Yorkshire Pathway is to undertake radiology investigations internally and MRI as necessary. Following this, the MSK Radiologist will send the patient on to Leeds if assessment by the Specialist Sarcoma MDT is required.
  • The Referrer will be notified of radiology investigation findings and further management plan as appropriate.

Referral Instructions

Supporting Information

Assurance & Governance

  • This guidance was developed on: 05.2017
  • This guidance was ratified by: OSCAR Assurance Group
  • Date ratified: 05.2017
  • Publication Date: 05.2017
  • Review Date: 05.2019
  • Ref No: CA10 – 05.2017
Any feedback or suggestions to improve this guidance should be sent to: oscaradmin@this.nhs.uk
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