Flat Dose or Weight-Based Dose of Mitomycin during Cytoreductive Surgery for the Treatment of Advanced Gastrointestinal Malignancy

Inclusion Criteria

• Patients diagnosed with one of the following: * Low-grade appendiceal mucinous neoplasm * Pseudomyxoma peritonei * Appendiceal cancer with peritoneal carcinomatosis * Colorectal cancer with peritoneal carcinomatosis Clinical diagnosis is required prior to surgery and pathologic diagnosis is confirmed from surgical pathology
• Age >= 18 years
• Eastern Cooperative Oncology Group (ECOG) performance status < 3
• Candidate for grossly complete cytoreductive surgery. Eligible patients will undergo surgery with intent of grossly complete cytoreduction, regardless of the final extent of cytoreduction achieved
• Life expectancy greater than 3 months
• Absolute neutrophil count >= 1,500/mcL
• Platelets >= 75,000/mcL
• Total bilirubin < 3 X upper limit of normal
• Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase [SGPT]) < 2.5 X upper limit of normal
• Creatinine =< institutional upper limit of normal (ULN) OR glomerular filtration rate (GFR) >= 50 mL/min/1.73 m^2
• Women of child-bearing potential and men must agree to use adequate contraception (barrier or hormonal plus barrier method of birth control; abstinence) for the duration of study participation
• Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria

• Any extra-abdominal metastases
• Untreated lung metastases
• High volume liver metastases are ineligible. Low volume (< 5 liver metastases) are typically eligible for CRS/HIPEC as long as liver lesions can be resected or ablated prior to or during CRS/HIPEC
• Known brain metastases
• Chemotherapy within 21 days prior to CRS/HIPEC or Radiotherapy within 4 weeks prior to entering the study. There is no limit on allowable number of prior lines of chemotherapy
• Presence of residual significant adverse events (i.e., Common Terminology Criteria for Adverse Events [CTCAE] version [v] 5.0, grade 3 or 4) attributed to prior cancer treatment. These residual adverse event (AE)s will be evaluated for eligibility exclusion at the discretion of the treating investigator
• Currently receiving any other investigational therapeutic agents
• History of allergic reactions attributed to compounds of similar chemical or biologic composition to mitomycin C
• Pregnant or breast-feeding women
• Uncontrolled ongoing illness, including but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements