Hepatic Arterial Infusion of Melphalan With Hepatic Perfusion in Treating Patients With Unresectable Liver Cancer

DISEASE CHARACTERISTICS:

* Histologically or cytologically confirmed hepatic malignancy

  * Unresectable disease
  * Disease predominantly in the parenchyma of the liver
  * One of the following primary tumor histologies:

    * Adenocarcinoma of gastrointestinal or other origin
    * Neuroendocrine tumor (except gastrinoma)
    * Primary hepatic malignancy (e.g., hepatocellular cancer or intra-hepatic cholangiocarcinoma)
    * Cutaneous or ocular melanoma (patients must have received prior regional melphalan therapy)
  * Hepatic metastases from colorectal tumors allowed provided patient has undergone prior first-line chemotherapy, including irinotecan or oxaliplatin
* Limited unresectable extrahepatic disease on preoperative radiological studies allowed if life-limiting component of progressive disease is in the liver

  * Limited extrahepatic disease includes, but is not limited to, the following:

    * Up to 4 pulmonary nodules each \< 1 cm in diameter
    * Retroperitoneal lymph nodes each \< 3 cm in diameter
    * Less than 10 skin or subcutaneous metastases each \< 1 cm in diameter
    * Asymptomatic bone metastases that have been or could be palliatively treated with external beam radiotherapy
    * Resectable solitary metastasis to any site
* Hormone receptor status:

  * Not specified

PATIENT CHARACTERISTICS:

Age

* 16 and over

Sex

* Male or Female

Menopausal status

* Not specified

Performance status

* ECOG 0-2

Life expectancy

* Not specified

Hematopoietic

* Platelet count ≥ 75,000/mm\^3
* Hematocrit \> 27%
* Absolute neutrophil count ≥ 1,300/mm\^3

Hepatic

* Bilirubin ≤ 2.0 mg/dL
* PT ≤ 2 seconds of upper limit of normal (ULN)
* AST and ALT ≤ 10 times ULN
* No Childs class B or C cirrhosis
* No portal hypertension by history, endoscopy, or radiologic studies

Renal

* Creatinine ≤ 1.5 mg/dL OR
* Creatinine clearance \> 60 mL/min

Cardiovascular

* No congestive heart failure
* LVEF ≥ 40%

Pulmonary

* No chronic obstructive pulmonary disease
* FEV\_1 ≥ 30% of predicted
* DLCO ≥ 40% of predicted

Immunologic

* No active infection
* No severe allergic reaction to iodine contrast agent that is not controlled by premedication with antihistamines or steroids
* No known hypersensitivity reaction to melphalan or heparin in the presence of a heparin induced thrombocytopenia (HIT) antibody

Other

* Weight \> 35 kg
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* No documented latex allergy
* No evidence of intracranial abnormalities which would lead to risk for bleeding with anticoagulation (e.g., stroke or active metastasis)
* No evidence of active ulcer disease

PRIOR CONCURRENT THERAPY:

Biologic therapy

* More than 1 month since prior biologic therapy and recovered

Chemotherapy

* See Disease Characteristics
* More than 1 month since prior chemotherapy and recovered

Endocrine therapy

* Premenopausal women (i.e., have had a period within the past 12 months) must be willing to undergo hormonal suppression during study treatment

Radiotherapy

* See Disease Characteristics
* More than 1 month since prior radiotherapy and recovered

Surgery

* No prior Whipple resection

Other

* Prior intrahepatic perfusion (with or without arterial infusion with floxuridine) or peripheral hepatic perfusion allowed provided the patient had a radiographic partial response of 3 months' duration after therapy
* No concurrent immunosuppressive drugs
* No concurrent chronic anticoagulation therapy