Radiation Segmentectomy for Early Hepatocellular Carcinoma is Curative

In this Expert Opinion, we provide the rationale for concluding that radiation segmentectomy (using RADSEG method), a technique of administrating ablative, complete necrosis-inducing trans-arterial Yttrium-90 (Y90) radiotherapy in limited-disease burden hepatocellular carcinoma (HCC), is curative. Currently, curative options for early stage and other carefully selected HCC patients include transplantation, resection, and ablation. Because of issues with organ availability, co-morbidities preventing resection, and tumor size and location limiting ablation, other treatments are necessary for this selected patient population. 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 radioembolization, applying RADSEG technique, be formally recognized as curative for early HCC.