Y90 Radiation Segmentectomy vs. TACE plus Microwave Ablation: Equivalent Pathologic Necrosis for HCC ≤5 cm on Explant

In HCC ≤5 cm bridged to transplant, radiation segmentectomy (Y90) and TACE+MWA showed equivalent tumor necrosis on explant: mean 79% vs 84% (p=0.48), complete necrosis 45% vs 62% (p=0.14). Tumor size ≤3 cm predicted CPN (OR 18.3, 95% CI 2.1–156.5).

• Single-center retrospective study of 53 treatment-naïve patients (40 tumors per arm) with HCC ≤5 cm who underwent locoregional therapy and later transplant.
• Complete radiologic response was associated with higher tumor necrosis (42.7% vs 26.6%, p=0.007).
• Limitations: non-randomized, retrospective, small sample, single-institution, no external validation.

RadPigeon summaries are original and for information only. They are not clinical advice.