目的　探讨影响中晚期肝细胞肝癌手术切除预后的因素。　方法　对 13 0例中晚期大肝癌随访 1～ 7年 ,采用单因素、多因素分析统计不同预后因素对患者生存率的影响。　结果　手术后 1,3 ,5年生存率分别为 81.7% ,2 4.3 % ,18.4%。单因素分析提示影响预后的因素为肝癌大小、是否早期复发、肝硬化情况、输血量 ;多因素分析提示肝癌大小、肿瘤早期复发是影响肝癌术后的预后因素。　结论　中晚期肝癌手术切除预后仍不理想 ,重视围手术期处理 ,预防术后早期复发有望提高手术疗效 Objective To explore the factors influencing the prognosis of surgical resection of hepatocellular carcinoma in the advanced stage. Methods One hundred and thirty-seven patients with advanced hepatocellular carcinoma of the middle and advanced stages were followed up for one to seven years. The influence of different prognostic factors on the survival rate was calculated by univariate and multivariate analysis. Results The 1,3 and 5 year survival rates were 81.7%, 23.3% and 18.4% respectively. Univariate analysis showed that the prognostic factors were the size of liver cancer, early recurrence, cirrhosis and blood transfusion; Multivariate analysis showed that the size of liver cancer and the early recurrence of tumor were the prognostic factors of postoperative liver cancer. Conclusions The prognosis of surgical resection for advanced hepatocellular carcinoma is still not satisfactory. It emphasizes perioperative management and prevention of early recurrence after operation is expected to improve the surgical outcome