In our study, both repeated SR and RFA completely eliminated recurrent HCC and achieved near 100% response rates. However, a second recurrence of HCC is not uncommon. Chan et al  showed 72.4% of patients in the repeated SR group and 84.4% of patients in the RFA group developed a second recurrence with a similar median time from treatment of the first recurrence to second recurrence (6.3 vs. 9.5 months, p = 0.25). Our study showed 79.8% of patients in the repeated SR group and 71.9% of patients in the RFA group developed a second recurrence with a similar median time from treatment of the first recurrence to second recurrence (11 vs. 10 months, p = 0.74).