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

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