Surgery With or Without Radiofrequency Ablation Followed by Irinotecan in Treating Patients With Colorectal Cancer That is Metastatic to the Liver

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologically confirmed primary colorectal adenocarcinoma
• •Hepatic metastases that are considered completely resectable
• •* No more than 4 metastases by dual phase CT scan OR
• •Hepatic metastases that are not completely resectable but are amenable to complete destruction with resection and radiofrequency ablation
• •* More than 4 metastases allowed if all disease can be resected or destroyed in situ with radiofrequency ablation
• •No extrahepatic disease in any location
• •No recurrent or second primary colorectal cancer by colonoscopy within the past year
• •Received prior adjuvant chemotherapy with a fluorouracil-based regimen with the last dose at least 1 month prior to surgery
• •No prior radiofrequency ablation with residual viable intrahepatic disease by CT scan
• •No plans to be treated with radiofrequency ablation alone without surgical resection
• •PATIENT CHARACTERISTICS:
• •Age:
• •18 and over
• •Performance status:
• •ECOG 0-1
• •Life expectancy:
• •Not specified
• •Hematopoietic:
• •Absolute neutrophil count at least 1,500/mm\^3
• •Platelet count at least 100,000/mm\^3
• •Hepatic:
• •Bilirubin no greater than 1.5 times upper limit of normal (ULN)
• •AST and ALT no greater than 5 times ULN
• •No Gilbert's disease or other known defect in hepatic conjugation or glucuronidation
• •Renal:
• •Creatinine no greater than 1.5 times ULN
• •Cardiovascular:
• •No myocardial infarction within the past 6 months
• •No congestive heart failure requiring therapy
• •Other:
• •Not pregnant or nursing
• •Fertile patients must use effective contraception during and for 30 days after study
• •No other malignancy within the past 5 years except inactive non-melanoma skin cancer or carcinoma in situ of the cervix
• •No active serious infection
• •No other serious underlying medical condition or severe concurrent disease that would preclude study participation
• •No dementia, significantly altered mental status, or psychiatric illness that would preclude study participation
• •No known hypersensitivity to irinotecan
• •No known infection with HIV or AIDS
• •No uncontrolled diabetes mellitus
• •No history of seizures
• •No drug or alcohol abuse within the past year
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy:
• •Not specified
• •Chemotherapy:
• •See Disease Characteristics
• •No prior irinotecan
• •Endocrine therapy:
• •Not specified
• •Radiotherapy:
• •No prior radiotherapy to more than 30% of bone marrow
• •No prior radiotherapy to the liver
• •At least 3 months since prior radiotherapy to the pelvis or other areas
• •Surgery:
• •See Disease Characteristics
• •No prior resection of hepatic metastases (wedge biopsy allowed)
• •Other:
• •No concurrent phenytoin, phenobarbital, or other antiepileptic medication
• •No concurrent enrollment in other investigational drug trials