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Neoadjuvant radiotherapy (NART) is often used in the treatment of extremity soft tissue sarcomas (STS) including myxoid liposarcoma (MLS). Postoperative major wound complications (WC) are a well-recognised problem following NART.
Aims:
A review of the literature regarding the definition and incidence of WC following NART and surgery for STS and a retrospective review of a single surgeon series of 25 MLS.
Methods:
A literature search for papers focusing on MLS, NART and WC was performed, with 12 papers being reviewed. Retrospective data from a single surgeon series of 25 patients with MLS, treated with NART and surgery, were reviewed, focussing on WC.
Results:
The average rate of WC from the 12 papers included was 29·4% (20–47%), and the average rate of reoperation was 15·6% (7·3–24%). There were a range of definitions used for WC, most commonly O’Sullivan’s definition. In the single surgeon series, two patients (8%) developed WC and were treated conservatively, and there were no reoperations within 120 days.
Conclusion:
This literature review identified that there was a lack of consistency between the definitions used for major WC. The single surgeon series of MLS showed WC that were lower when compared to the reviewed literature (8% versus 29·4%).
Vulval cancer is rare and constitutes approximately 3% of gynaecological cancers worldwide. The incidence of vulval cancer has increased since the mid-1990s owing to the increased incidence in younger women, which has doubled over the past 30 years. Clinical trials in vulval cancer can be divided into two categories-trials in women with vulval cancer and, more recently, trials on the prevention of vulval cancer by preventing or treating human papillomavirus (HPV)-related vulval intraepithelial neoplasia (VIN). Numerous studies have tried to evaluate the role of neoadjuvant radiotherapy and/or chemotherapy in this disease to reduce the extent of surgery. Early studies involving the medical treatment of VIN with imiquimod, cidofovir and especially therapeutic vaccines appear promising in the prevention of vulval cancer. However, the greatest effect on preventing cancer is likely to arise as a result of vaccination programmes of the prophylactic HPV vaccines, assuming adequate uptake of the vaccine.
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