Table 3 showed the postoperative and long term outcomes of patients receiving repeated SR and RFA for the treatment of the first recurrence of HCC. Seven (16%) patients developed a total of 10 operation related complications in the repeated SR group, and one (2%) patient experienced a major complication: death due to bile duct injury with bile leakage and septic shock. In the RFA group, four (7%) patients developed a total of six procedure related complications, and there was no complication related mortality. The incidences of treatment related morbidity (p = 0.14) and mortality (p = 0.25) did not differ in the two groups. The total hospital day was longer in the repeated SR group (13 vs. 5 days, p < 0.05). The overall treatment response rates were similar (repeated SR 100% vs. RFA 98%, p = 0.67). At the time of analysis, 30.2% of patients over the median follow up time of 53 months in the repeated SR group and 28.1% patients over the median follow up time of 54 months in the RFA group remained free of a second recurrence. The median time from the treatment of recurrent HCC to developing a second recurrence was 11 months in the repeated SR group and 10 months in the RFA group (p = 0.74). Intrahepatic recurrence was the most common recurrence pattern in both groups. For the treatment of the second recurrence of HCC, 55% of patients received curative treatment in the repeated SR group, whereas 67% of patients received curative treatment in the RFA group.