Radiation segmentectomy for early hepatocellular carcinoma is curative
Riad Salem, Siddharth A. Padia, Beau Toskich, Jon Callahan, Kirk Fowers, B. Geller, Guy E. Johnson, Laura Kulik, Tushar Patel, Robert J. Lewandowski, Edward Kim
Abstract
In this expert opinion, we provide the rationale for concluding that radiation segmentectomy (using the RADSEG method) - a technique involving the transarterial delivery of an ablative, complete necrosis-inducing dose of yttrium-90 radiotherapy - is curative in limited-disease burden hepatocellular carcinoma (HCC). Currently, curative options for early stage and other carefully selected HCC cases include transplantation, resection, and ablation. Because of issues with organ availability, co-morbidities preventing resection, and tumour size and location limiting ablation, other treatments are necessary for this selected patient population. The RADSEG method has evolved into an intra-arterial approach in this setting, with long-term outcomes comparable to ablation, resection, and transplantation. It is proposed that yttrium-90 radioembolisation, applying the RADSEG technique, be formally recognised as curative for early HCC.