Hepatic Arterial Infusion With Floxuridine and Systemic Irinotecan After Surgery in Treating Patients With Hepatic (Liver) Metastases From Colorectal Cancer

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologically confirmed metastatic colorectal adenocarcinoma
• •* Primary colorectal adenocarcinoma that has been completely resected (R0 disease)
• •* No evidence of residual, viable tumor by abdominal/pelvic helical CT scan or MRI with IV contrast
• •* Metastatic disease
• •* No more than 9 liver metastases
• •* All lesions completely resected or completely treated by ablation (with or without resection)
• •* All lesions treated by ablation must have been less than 5 cm in size and at least 5 mm away from main/left/right portal vein, common bile duct, and inferior vena cava
• •* All resected lesions must have a negative surgical margin (R0)
• •Disease progression after prior systemic irinotecan for metastatic disease allowed
• •No extrahepatic metastases confirmed by chest CT scan except colorectal mesenteric lymph node metastases resected at the time of primary tumor resection
• •* No other prior resection of extrahepatic metastases
• •Must have the entire liver remnant perfused with a single catheter
• •Must have a nuclear medicine macro-aggregated albumin flow scan to confirm the area of pump perfusion before study registration
• •PATIENT CHARACTERISTICS:
• •Age
• •18 and over
• •Performance status
• •ECOG 0-2 OR
• •Zubrod 0-2
• •Life expectancy
• •Not specified
• •Hematopoietic
• •WBC at least 3,000/mm\^3
• •Absolute granulocyte count at least 1,500/mm\^3
• •Absolute neutrophil count at least 1,500/mm\^3
• •Platelet count at least 100,000/mm\^3
• •Hepatic
• •Bilirubin no greater than 2 mg/dL
• •Alkaline phosphatase no greater than 2.0 times upper limit of normal (ULN)
• •AST and ALT no greater than 2.0 times ULN
• •No active hepatitis B or C infection
• •No histological evidence of cirrhosis
• •Renal
• •Creatinine no greater than 1.5 times ULN
• •Calcium less than 1.3 times ULN
• •Other
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must use effective contraception
• •* Postmenopausal women must be amenorrheic for at least 12 consecutive months to be deemed not fertile
• •Medically fit to begin chemotherapy between 4 and 8 weeks after surgery
• •Prior cancer allowed if all of the following criteria are met:
• •* Undergone potentially curative therapy for all prior malignancies
• •* No other malignancy within the past 5 years except the following:
• •* Effectively treated basal cell or squamous cell skin cancer
• •* Carcinoma in situ of the cervix that has been effectively treated by surgery alone
• •* Lobular carcinoma in situ of the ipsilateral or contralateral breast treated by surgery alone
• •* No evidence of recurrence of any prior malignancy
• •No prior hepatic arterial infusion pump malfunction, malperfusion, or infection
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy
• •No concurrent immunologic or biologic therapy
• •Chemotherapy
• •No prior chemotherapy within 4 weeks before hepatic resection or hepatic ablation (with or without resection)
• •No prior hepatic arterial infusion with fluorouracil or floxuridine
• •Radiotherapy
• •No concurrent adjuvant radiotherapy to the pelvis
• •No other concurrent radiotherapy
• •Other
• •No other concurrent systemic therapy