Abstract: Objective This study was conducted to investigate the efficacy of ultrasound(US)-guided radiofrequency ablation ( RFA ) in the treatment of patients with small hepatocellular carcinoma (sHCC), and analyze the risk factors affecting the survivals. Methods 102 patients with sHCC were encountered in our hospital between December 2019 and January 2021, and all underwent US-guided RFA. The patients in our series were followed-up for two years. The univariate and multivariate Logistic regression analysis were applied to analyze the factors affecting the survivals of patients after RFA treatment. Results One-month observation showed progression diseases in 6 cases, stable diseases in 21 cases, partial remission in 52 cases and complete remission in 23 cases, with the objective response rate of 73.5%; the one-year and two-year survival rates were 90.2% and 77.5%; there were no significant differences respect to the ages, gender, history of alcohol abuse, underlying hepatitis B viral infection as well as plasma prothrombin time international normalized ratio and blood platelet counts between died and survived patients (P>0.05), while the percentages of Child-Pugh class C, low differentiation of tumor cells, lesions adjacent to vessels, without antiviral therapy of nucleos(t)des and serum AFP level in dead patients at admission were 43.5%, 34.8%, 69.6%, 69.6% and (292.4±28.5) ug/L, all significantly higher than , and serum albumin level was (32.2±4.5) g/L, much lower than in survivors; the Logistic analysis showed that high serum AFP levels, Child-Pugh class C, foci adjacent to blood vessels and without antiviral therapy were all the independent risk factors (P<0.05) impacting the long-term survival of patients with HCC after RFA therapy . Conclusion The RFA under US-guidance in managing patients with sHCC is definitely efficacious, and take the risk factors affecting the survival into consideration and intervenes with them in time might prolong the survivals of patients with sHCC.

Key words: Hepatoma, Radiofrequency ablation, Ultrasound-guidance, Therapy, Prognosis