Stop signals (contraindications) for debulking:
(1) poor operative risk (patient not expected to survive surgery)
(2) liver metastases or evidence of distant metastases
(3) inability to resect the primary tumor mass
(4) inability to re-establish gastrointestinal function
Indications for conservative therapy:
(1) high grade malignancy
(2) past history of peritoneal seeding
(3) shortened mesentery on CT scan
(4) multiple sites of bowel segment obstruction due to metastatic tumor
(5) tumor nodules > 5 cm in diameter involving small bowel
(6) short interval between surgeries
(7) serous or bloody ascites
(8) histology non-mucinous
(9) absence of a large, resectable/localized recurrence
