Management of HCC: Focus on Radiation Segmentectomy Part 1

[Dr. Tyler Sandow]:
I'll say we follow the BCLC algorithm as closely to the T as possible. If there's a patient that meets criteria for ablation, then we're going to ablate it unless we feel like it's a high-risk ablation and Y90 made more sense. We go for, our process is, regardless of whether or not they're going to transplant, we want to give them, even if it's a bridging strategy, we want to give them the most durable outcome possible. I think if you look at the BCLC structure, the durability comes from ablative modalities, whether that be Y90 or ablation.

The majority of the patients that we see either have pretty advanced cirrhosis, so if they weren't transplant eligible, our surgeons don't necessarily want to take an advanced cirrhotic to resection. That's where an alternate ablated modality that probably provides just as durable of a result makes the most sense.

We have, and we can dive in, at some point, we can talk about the research we do. We've been tracking outcomes on these patients for a very long time. We've noticed trends in our outcomes to allow us to alternate a little bit, or deviate, I should say, a little bit away from a purist BCLC scheme. We don't necessarily ablate everybody anymore because we've noticed trends in our data that would probably push us more towards an intra-arterial therapy, and we know that Y90 is probably going to be the best for those.