Radiation segmentectomy for early hepatocellular carcinoma is curative.

Area of Science:

• Hepatobiliary oncology
• Interventional radiology
• Radiation oncology

Background:

• Hepatocellular carcinoma (HCC) requires curative treatments like transplantation, resection, or ablation.
• Limitations of current curative options include organ availability, patient comorbidities, and tumor characteristics.
• There is a need for alternative curative therapies for selected HCC patients.

Purpose of the Study:

• To provide the rationale for considering radiation segmentectomy (RADSEG) as a curative treatment for limited-disease burden HCC.
• To highlight the efficacy of the RADSEG method in HCC management.
• To advocate for the formal recognition of yttrium-90 radioembolisation using RADSEG as a curative option for early HCC.

Main Methods:

• The RADSEG method involves transarterial delivery of yttrium-90 radiotherapy.
• This technique aims to induce complete necrosis in the targeted liver segments.
• The approach has evolved into an intra-arterial method for HCC treatment.

Main Results:

• Long-term outcomes of RADSEG are comparable to established curative treatments such as ablation, resection, and transplantation.
• The RADSEG method demonstrates effectiveness in managing early-stage and selected HCC cases.
• The technique addresses limitations associated with traditional curative options.

Conclusions:

• Radiation segmentectomy (RADSEG) using yttrium-90 radiotherapy is proposed as a curative treatment for limited-disease burden HCC.
• The RADSEG method offers a viable alternative for patients unsuitable for transplantation, resection, or ablation.
• Formal recognition of yttrium-90 radioembolisation with RADSEG as curative for early HCC is recommended.