We address the decay in open chaotic quantum systems and calculate semiclassical corrections to the classical exponential decay. We confirm random matrix predictions and, going beyond, calculate Ehrenfest time effects. To support our results we perform extensive numerical simulations. Within our approach we show that certain (previously unnoticed) pairs of interfering, correlated classical trajectories are of vital importance. They also provide the dynamical mechanism for related phenomena such as photoionization and photodissociation, for which we compute cross-section correlations. Moreover, these orbits allow us to establish a semiclassical version of the continuity equation.