PERSPECTIVE article
Front. Surg.
Sec. Surgical Oncology
This article is part of the Research TopicOptimizing Outcomes in Pelvic Exenteration Surgery for Advanced Pelvic MalignanciesView all 4 articles
Quality improvement in exenteration for advanced pelvic malignancy: the role of a registry
Provisionally accepted
- 1University of Otago, Christchurch, Christchurch, New Zealand
- 2Christchurch Hospital, Christchurch, New Zealand
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Abstract Pelvic exenteration, once regarded as an "extreme option for hopeless cases," has evolved into a standard of care for selected patients with advanced or recurrent pelvic malignancy. In parallel with technical and peri-operative advances, there has been a global shift toward structured quality improvement and registry-based outcome measurement. Registries are powerful tools for quality improvement and benchmarking. This paper outlines the historical evolution of exenterative surgery, the development of surgical quality registries, and their role in benchmarking performance. It highlights the success of international collaboratives such as PelvEx in standardising definitions and outcomes, and discussed key performance indicators (KPIs) relevant to exenterative surgery. These include oncological, peri-operative, and survivorship outcomes, supported by appropriate risk stratification. Establishing high-quality, prospectively maintained registries enables meaningful comparison between units, facilitates clinical governance, and strengthens advocacy for resources. Ultimately, registry-driven data are essential for refining surgical quality, optimising patient selection, and improving long-term survivorship in this complex patient cohort. This is particularly relevant given the increasing variation in neoadjuvant therapies.
Keywords: Locally advanced rectal cancer, Pelvic Exenteration, quality improvement in surgery, Recurrent rectal cancer, registries in surgery
Received: 03 Nov 2025; Accepted: 27 Jan 2026.
Copyright: © 2026 Glyn, Turner and Frizelle. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tamara Glyn
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