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BackTable / VI / Podcast / Episode #377

Management of HCC: Focus on Radiation Segmentectomy Part 1

with Dr. Juan Gimenez and Dr. Tyler Sandow

In this episode, host Dr. Chris Beck interviews Dr. Juan Gimenez and Dr. Tyler Sandow. Juan and Tyler are both interventional radiologists in New Orleans, Louisiana who practice at Ochsner Health System - one of the United States’ leading transplant centers. As a result, both doctors have significant experience in Y-90 radiation segmentectomy and other complex procedures for treatment of hepatocellular carcinoma (HCC).

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Management of HCC: Focus on Radiation Segmentectomy Part 1 with Dr. Juan Gimenez and Dr. Tyler Sandow on the BackTable VI Podcast)
Ep 377 Management of HCC: Focus on Radiation Segmentectomy Part 1 with Dr. Juan Gimenez and Dr. Tyler Sandow
00:00 / 01:04

BackTable, LLC (Producer). (2023, October 23). Ep. 377 – Management of HCC: Focus on Radiation Segmentectomy Part 1 [Audio podcast]. Retrieved from https://www.backtable.com

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Podcast Contributors

Dr. Juan Gimenez discusses Management of HCC: Focus on Radiation Segmentectomy Part 1 on the BackTable 377 Podcast

Dr. Juan Gimenez

Dr. Juan Gimenez is an interventional and diagnostic radiologist with Ochsner Health in New Orleans, Louisiana.

Dr. Tyler Sandow discusses Management of HCC: Focus on Radiation Segmentectomy Part 1 on the BackTable 377 Podcast

Dr. Tyler Sandow

Dr. Tyler Sandow is an interventional radiologist with Ochsner Health in New Orleans, Louisiana.

Dr. Christopher Beck discusses Management of HCC: Focus on Radiation Segmentectomy Part 1 on the BackTable 377 Podcast

Dr. Christopher Beck

Dr. Chris Beck is a practicing interventional radiologist with Regional Radiology Group in New Orleans.

Synopsis

Juan and Tyler start the episode by telling us about how their practice has evolved over the years, their experience on tumor boards, and advice for building strong relations with transplant surgeons. The doctors also tell us about their approach to working-up patients with HCC, the variety of treatment modalities, and overall timeline to transplant.

Next we discuss considerations for building an effective interventional oncology service. Taking full ownership at every step of the way is critical to this goal. To conclude the episode, Juan and Tyler discuss the Barcelona Clinic Liver Cancer (BCLC) staging algorithm, their research, and other factors that guide their treatment plan. Stay tuned for Part 2 of this discussion, releasing later this week!

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Transcript Preview

[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.

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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