The successful treatment of recurrent lower reproductive tract cancers, especially cervical cancers, requires a dramatic surgical approach to achieve cure. Pelvic exenteration continues to be the only curative option in certain patients with centrally recurrent cervical, vaginal, or vulvar cancers, as well as colorectal cancers. Currently, operative mortality rates are 3-5%, the major perioperative complication rate is 30-44%, and the overall 5-year survival rate in patients who successfully undergo the procedure is 20-50%.