Inclusion Criteria:

- Age 18 - 75 years, who refused surgery or first recurrence after hepatectomy

- A solitary HCC 3.1-7.0cm in diameter, or 2-3 lesions, sums of diameters ≤ 7.0cm

- Lesions being visible on ultrasound (US) and with an acceptable/safe path between the
lesion and the skin as shown on US

- No extrahepatic metastasis

- No imaging evidence of invasion into the major portal/hepatic vein branches

- No history of encephalopathy, ascites refractory to diuretics or variceal bleeding

- A platelet count of > 40,000/mm3

- No previous treatment of HCC except liver resection

Exclusion Criteria:

- Patient compliance is poor

- Previous or concurrent cancer that is distinct in primary site or histology from HCC,
EXCEPT cervical carcinoma in situ, treated basal cell carcinoma, superficial bladder
tumors (Ta, Tis & T1). Any cancer curatively treated > 3 years prior to entry is
permitted

- History of cardiac disease:

- congestive heart failure > New York Heart Association (NYHA) class 2

- active coronary artery disease (myocardial infarction more than 6 months prior
to study entry is permitted)

- cardiac arrhythmias requiring anti-arrhythmic therapy other than beta blockers,
*calcium channel blocker or digoxin

- uncontrolled hypertension (failure of diastolic blood pressure to fall below 90
mmHg, despite the use of 3 antihypertensive drugs)

- Active clinically serious infections (> grade 2 National Cancer Institute
[NCI]-Common Terminology Criteria for Adverse Events [CTCAE] version 3.0)

- Known history of human immunodeficiency virus (HIV) infection

- Known Central Nervous System tumors including metastatic brain disease

- Patients with clinically significant gastrointestinal bleeding within 30 days prior
to study entry

- Distantly extrahepatic metastasis