Hepatic Arterial Infusion With Floxuridine and Dexamethasone Combined With Combination Chemotherapy in Treating Patients With Colorectal Cancer That Has Spread to the Liver

Criteria the registry did not label

• DISEASE CHARACTERISTICS:
• Histologically confirmed colorectal adenocarcinoma metastatic to the liver
  • Previously treated or untreated disease
  • No clinical or radiographic evidence of extrahepatic disease
• Primary tumor may be present at study registration provided it is not obstructing the intestinal lumen or is significantly bleeding
  • If present, the primary tumor will be resected at the time of pump placement
• Must have inoperable liver metastases confirmed by 2-3 hepatobiliary surgeons and the assigned radiologist
  • Liver metastases \< 70% of the liver parenchyma
  • Inoperable liver metastases is defined by one of the following:
  • More than 6 metastases in a single lobe with one lesion ≥ 5 cm
  • At least 6 metastases distributed diffusely in both lobes of the liver
  • When a margin-negative resection would require resection of all three hepatic veins, both portal veins, or the retrohepatic vena cava
  • Requires a resection that leaves \< 2 hepatic segments (not including the caudate lobe) behind with adequate arterial or portal inflow, venous outflow, and biliary drainage
• No ascites or hepatic encephalopathy
• No history of primary CNS tumors
  • PATIENT CHARACTERISTICS:
• Karnofsky performance status 60-100%
• WBC ≥ 3,000/mm\^3
• ANC ≥ 1,500/mm\^3
• Platelet count ≥ 100,000/mm\^3
• INR \< 1.5
• Hemoglobin ≥ 9 g/dL
• Creatinine ≤ 1.5 mg/dL
• Total bilirubin ≤ 1.5 mg/dL
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• Physically able to tolerate major partial hepatectomy
• No active infection
• No concurrent active malignancies, except potentially resectable primary colorectal tumor
• No bleeding diathesis or coagulopathy
• No history of serious systemic disease, including any of the following:
  • Myocardial infarction within the past 6 months
  • Uncontrolled hypertension (i.e., blood pressure \> 150/100 mm Hg on medication)
  • Unstable angina
  • New York Heart Association class II-IV congestive heart failure
  • Unstable symptomatic arrhythmia requiring medication
  • Chronic atrial arrhythmia (i.e., atrial fibrillation or paroxysmal supraventricular tachycardia) allowed
  • Peripheral vascular disease ≥ grade 2
• No serious or nonhealing active wound, ulcer, or bone fracture
• No history of seizures not well controlled with standard medical therapy
• No stroke or transient ischemic attack within the past 6 months
• No concurrent obstruction of the gastrointestinal or genitourinary tract
  • PRIOR CONCURRENT THERAPY:
• At least 4 weeks since prior radiotherapy to the pelvis
• Prior chemotherapy allowed
• No prior radiotherapy, hepatic thermal ablation, or resection (other than biopsy) to the liver
• No prior floxuridine
• No prior hepatic arterial infusion
• No concurrent chronic aspirin (\> 325 mg/day) or nonsteroidal anti-inflammatory medications known to inhibit platelet function
• No other concurrent investigational agents