Currently there is no consensus which staging system is best in predicting the survival of patients with hepatocellular carcinoma (HCC). The aims of this stud y were to identify independent predictors of survival and to compare 7 available prognostic staging systems in patients with HCC. A total of 239 consecutive pat ients with cirrhosis and HCC seen between January 1, 2000, and December 31, 2003 , were included.Demographic, laboratory, and tumor characteristics and performan ce status were determined at diagnosis and before therapy.Predictors of survival were identified using the Kaplan-Meir test and the Cox model. Sixty-two perce nt of patients had hepatitis C, 56%had more than 1 tumor nodule, 24%had portal vein thrombosis, and 29%did not receive any cancer treatment. At the time of c ensorship, 153 (63%) patients had died. The 1-and 3-year survival of the enti re cohort was 58%and 29%, respectively. The independent predictors of surviv- al were performance status (P< .0001),MELD score greater than 10 (P = .001), p ortal vein thrombosis (P=.0001), and tumor diameter greater than 4 cm (P = .001) . Treatment of HCC was related to overall su- rvival. The Barcelona Clinic Liver Cancer(BCLC) staging system had the best in dependent predictive power for survival when compared with the other 6 prognosti c systems. In conclusion, performance status, tumor extent, liver fun- ction, and treatmentwere independent predictors of survival mostly in patients with cirrhosis and HCC. The BCLC staging system includes aspects of all of thes e elements and provided the best prognostic stratification for our cohort of pat ients with HCC. Currently there is no consensus which staging system is best in predicting the survival of patients with hepatocellular carcinoma (HCC). The aims of this stud y were to identify independent predictors of survival and to compare 7 available prognostic staging systems in patients with HCC. A total of 239 consecutive pat ients with cirrhosis and HCC seen between January 1, 2000, and December 31, 2003, were included. Demographic, laboratory, and tumor characteristics and performan ce status were determined at diagnosis and before therapy. Predictors of survival were identified using the Kaplan-Meir test and the Cox model. Sixty-two perce nt of patients had hepatitis C, 56% had more than 1 tumor nodule, 24% had portal vein thrombosis, and 29% did not receive any cancer treatment. At the time of c ensorship, 153 (63%) patients had died. The 1-and 3-year survival of the enrolled cohort was 58% and 29%, respectively. The independent predictors of survival were performance status (P <. 0001), MELD sc Oral greater than 10 (P = .001), p ortal vein thrombosis (P = .0001), and tumor diameter greater than 4 cm (P = .001). Treatment of HCC was related to overall suvival. The Barcelona Clinic Liver cancer (BCLC) staging system had the best in dependent predictive power for survival when compared with the other 6 prognosti c systems. In conclusion, performance status, tumor extent, liver function, and treatment we are independent predictors of survival mostly in patients with cirrhosis and HCC. The BCLC staging system includes aspects of all of the elements and provide the best prognostic stratification for our cohort of patients with HCC.