Standard Therapy With or Without Surgery and Mitomycin C in Treating Patients With Advanced Limited Peritoneal Dissemination of Colon Cancer

DISEASE CHARACTERISTICS:

* Histologically or cytologically confirmed colon adenocarcinoma meeting the following criteria:

  * Newly diagnosed disease
  * Advanced disease
  * Confirmed synchronous or metachronous limited peritoneal disease dissemination
  * No appendiceal or rectal cancer
  * No signet ring cell type
* Disease amenable to complete cytoreduction surgery as indicated by:

  * Peritoneal Cancer Index (PCI) ≤ 20 by helical CT scan and/or staging laparoscopy
  * No parenchymal hepatic metastases
  * No clinical (jaundice), biochemical (abnormally elevated serum bilirubin and/or alkaline phosphatase), or radiological (by ultrasound, CT scan, or MRI) biliary obstruction
  * No symptomatic malignant ascites requiring palliative paracentesis
  * Small volume of disease in the gastro-hepatic ligament defined by a \< 5 cm mass in the epigastric region on cross-sectional imaging
  * No cross-sectional imaging findings indicative of multi-segmental (\> 1 site) small bowel obstruction, small bowel loops matted together, or gross disease of the small bowel mesentery characterized by distortion, thickening, or loss of mesenteric vascular clarity
  * No clinical or radiological evidence of hematogenous or distant nodal (retroperitoneal, pelvic, mediastinal, peri-portal, or peri-aortic) metastasis

PATIENT CHARACTERISTICS:

* ECOG performance status 0-1
* ANC \> 1,200/mm³
* WBC \> 4,000/mm³
* Platelet count 150,000/mm³
* INR ≤ 1.5

  * Patients on therapeutic anticoagulant for unrelated medical condition such as atrial fibrillation or anti-thrombocyte treatment allowed provided treatment can be withheld for operation
* Total serum bilirubin ≤ 1.5 mg/dL (\> 1.5 mg/dL for patients with Gilbert syndrome)
* Alkaline phosphatase \< 2.5 times upper limit of normal (ULN)
* AST \< 1.5 times ULN
* Serum creatinine normal
* BUN normal
* Not pregnant or nursing
* Fertile patients must use effective contraception
* No history of severe congestive heart failure or severe pulmonary disease

  * Patients who are status post-revascularization procedures with satisfactory cardiac function are eligible
* No acute myocardial infarction within the past 6 months
* No significant history of a medical problem or co-morbidity (e.g., severe congestive heart failure or active ischemic heart disease) that would preclude a major abdominal operation
* No concurrent second malignancy requiring systemic therapy
* No psychiatric or addictive disorders, or other conditions that would preclude the patient from meeting the study requirements

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
* No prior second-line systemic treatment for metastatic colon adenocarcinoma

  * Patients who received prior adjuvant therapy for colon adenocarcinoma and/or prior first-line systemic therapy for metastatic colon adenocarcinoma are eligible