Y90 Radioembolization Prior to Surgical Resection or Radiofrequency for Hepatocellular Carcinoma in Cirrhotic Liver

Inclusion Criteria:

* Age ≥18 years.
* Cirrhotic liver demonstrated by typical liver dysmorphy on imaging and/or liver biopsy.
* HCC with at least one lesion measuring more than 1 cm in diameter with a single dynamic imaging technique (CT or MRI), showing intense arterial uptake followed by washout of contrast in the venous-delayed phases, or diagnosed by biopsy.
* Borderline resectable disease eligible for surgical resection or radiofrequency destruction.
* No extra-hepatic dissemination.
* ECOG Performance status \< 2.
* Women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
* Signed written informed consent (approved by an Independent Ethics Committee) obtained prior to any study specific baseline procedures.

Exclusion Criteria:

* Decompensated cirrhosis (Child Pugh B, C).
* Extra-hepatic tumour spread.
* Previous or concomitant malignancies within five years other than basal cell carcinoma of the skin.
* Pregnancy, lactation or refusal to use adequate contraceptive measures (hormonal or barrier method of birth control, abstinence).
* Pre-existing other hepatic disease (liver abscess, hepatic sarcoidosis or tuberculosis, sclerosing cholangitis, …).
* Previous trans-arterial radioembolization (TARE).
* History of allergic reactions attributed to compounds of similar chemical or biologic composition of the administered materials.
* Bleeding diathesis, history of cardiovascular ischemic disease or cerebrovascular incident within the last six months.
* Major surgery within four weeks.
* Uncontrolled concurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
* Uncontrolled Diabetes.