Venchiarutti RL, et al. - Given that for advanced or recurrent malignancy confined to the pelvis, pelvic exenteration (PE) provides a potentially curative option, researchers sought to delineate changing trends in the extent of resection, postoperative complications, mortality and overall survival following PE surgery. Based on time periods, they divided consecutive patients who underwent PE at a single institution in Sydney, Australia, into three groups, reflecting annual surgical volume: 1994–2006 (20 or fewer procedures per year), 2007–2013 (21–50 procedures per year) and 2014–2017 (over 50 procedures per year). They noted an increase in the rate of lateral and posterior compartment resections and bony pelvis and neurovascular excision over time. Significant increase in the proportion of patients undergoing reconstruction, who received vertical rectus abdominus myocutaneous flaps, was observed. Over the study interval, there was also an increase in rates of wound infection, dehiscence, and abdominal and pelvic collections. Further, a decrease in short-term mortality, and improvement in 1- and 3-year survival rates are reported. Findings suggest undertaking of more complex PE resections with technical and surgical advancements, with the improvement of R0 and mortality rates with higher annual volume.