Radiation segmentectomy for early hepatocellular carcinoma is curative

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.