Hepatic artery interventional embolization chemotherapy and radiofrequency ablation improves overall survival in patients with recurrent hepatocellular carcinoma Recent studies have shown that patients with hepatocellular carcinoma treated with hepatic artery interventional embolization chemotherapy (TACE) followed by radiofrequency ablation (RFA) of residual or recurrent lesions have significantly improved overall survival, but tumor recurrence is relatively frequent and early. (Gut Liver. 2014, 8:543) This study analyzed the outcomes and predictors of 101 patients with hepatocellular carcinoma who underwent RFA after recurrence of TACE therapy. All patients were treated with RFA between April 2007 and August 2010 at Samsung Medical Center in Korea, with a median age of 63 years and 76% being male. After RFA treatment, patients had an overall survival rate of 93.1% at 1 year, 65.4% at 3 years, and 61% at 5 years. The cumulative survival rate was higher in patients with lower serum alpha-fetoprotein (AFP) levels than in those with higher serum AFP levels (1-year survival 98.2% vs. 87%, 3-year survival 79.1% vs. 49.7%, 5-year survival 73.7% vs. 47.3%, P=0.004). Among all patients, 95 patients developed recurrence of hepatocellular carcinoma, with recurrence-free survival rates of 24%, 12% and 7% at 1, 2 and 3 years after RFA treatment, respectively. Among them, patients with higher serum AFP levels had significantly lower recurrence-free survival than those with lower serum AFP levels (73.9% vs. 87.1% at 2 months, 50% vs. 76% at 4 months, and 28.3% vs. 68.6% at 6 months, P<0.001). < p=""> Multifactorial analysis suggested that independent predictors of overall survival included Child-Pugh classification, recurrence pattern of hepatocellular carcinoma after TACE treatment, and serum AFP level after RFA treatment. In contrast, independent predictors of early patient recurrence included poorer response to TACE therapy, higher AFP levels, and larger tumor volume. The investigators concluded that despite the earlier and more frequent recurrence of these hepatocellular carcinoma patients after treatment, overall survival was better in patients treated with RFA for recurrent and residual foci after TACE therapy.