SP9.10 - The Sarcoma Hub and Spoke Diagnostic Service Can be Safely and Effectively Rolled-Out and Continued

Abstract Aims To understand the safety and effectiveness of the newly established Sarcoma Hub and Spoke Service (SHSS) in detecting malignancies through assessment of the performance of one Spoke Service in triaging lesions of concern. Methods Patients referred to our Diagnostic Service on the 2 week-wait pathway (2WW) and have had their lesion(s) of interest removed between an 18-month period were identified from our Hospital Information System. Data was collected for post-op histology, suspicion of diagnosis in the pre-op MDT, compatibility between the two, and whether patient was cleared from suspicion of malignancy before removal of the lesion. Results 119 patients meeting the criteria were identified. 90 had been cleared of suspicion for malignancy prior to surgery. 83/90 of these had samples sent for histology, yielding 82 benign and 1 malignant (dermatofibrosarcoma protruberans) results. Of the 29 patients who had excision biopsy on the 2WW, 5/29 returned histology for risk of (e.g. possible sarcoma or atypical lipoma) or confirmed malignancies. 46/119 cases were discussed at our SHSS MDT and have both pre-op MDT diagnosis records and histology results; 37/46 of these were compatible – all correctly predicted benign pathologies. Where pre-op MDT diagnosis and histology were incompatible, 1/9 predicted benign diagnosis but returned malignant histology. Conclusion Our SHSS Diagnostic Service’s process of triaging lesions concerning for sarcoma, including our MDT and surgical excision biopsies, is accurate. Preliminary data shows that the Sarcoma Hub and Spoke Service is a safe way to aid in diagnosing or ruling out soft tissue sarcoma.