e15198 Background: Hepatocellular carcinoma (HCC) is one of the most common cancers in the worldwide. In China, accounts for 70% patients are in the advanced stage at the first diagnosis. Sorafenib is the only systemic therapy in adavanced HCC. Radiofrequency ablation (RFA) therapy is an new and effective minimally invasive method recent years and there are rare reports of the combination of RFA and sorafenib for the advanced HCC. This study was designed to observe the effect and security of the combination therapy with RFA and sorafenib for advanced HCC. Methods: Twenty-four advanced HCC patients treated with sorafenib for more than 3 months were divided into two groups: sorafenib alone (13 cases) and RFA/sorafenib (11 cases). The tumor status of these patients was evaluated with computed tomography (CT) every 1~2 months. Progression-free survival (PFS), Overall survival(OS) and adverse effects were observed. Results: The median PFS in sorafenib group was 3.9 (2.3-5.8) months, while median PFS in RFA/sorafenib group was 6.8 (2.5-12.8) months. The combination therapy got longer PFS than treated sorafenib only (P<0.05). And the mOS in sorafenib group and RFA/sorafenib group were 16.3 vs. 22.7months (P<0.05). The side effect of radiofrequency ablation are mainly included fever and pain in puncture location. And only 2 patients got pleural effusion post-operation. All the side effects are disappeared in 2 weeks. The most common adverse reactions observed in patients treated with sorafenib were: fatigue, weight loss, rash or superficial skin desquamation, hand-foot skin reaction, hair loss, diarrhea, anorexia, nausea and abdominal pain, only 3 patients got severe hand-foot skin reaction and diarrhea, but all of them continued the sorafenib oraled after symptomatic treatment. Conclusions: RFA combined with sorafenib prolonged the PFS and OS in advanced HCC. This combination therapy is safe and effective for patients with advanced HCC. This approach could be a new choice for advanced HCC.