Abstract: Objective To investigate the factors influencing long-term survival in patients with hepatocellular carcinoma （HCC） with underlying hepatitis B virus （HBV） infection after hepatectomy. Methods 600 patients with hepatitis B virus related single large HCC were recruited in our hospital between January 2011 and January 2012, all patients received hepatectomy and followed-up for 5 years. Out of them,130 cases had tumors with diamiters greater than 5 cm,and 470 had tumors with less than 5 cm. The survival curve was drawn by the Kaplan-Meier method,the survival analysis was estimated by Log-rank test, and the Logistic regression analysis was applied to analyze the prognostic factors. Results There was no significant differences as respect to the clinical features （P>0.05） except the diameter of the tumors in the two groups;in 470 patients with small liver cancer,the survival time was 55.0±4.8 months,the tumor free survival time was 38.6±2.4 months,1 a,3 a and 5 a overall survival rates were 90.1%,71.5% and 57.1%,and the 1 a,3 a and 5 a tumor free survival rate was 57.1%,71.5% and 57.1%,while in 130 patients with large liver cancer,the survival time was 50.0±3.6 months （x2=12.175,P=0.001）,the tumor free survival time was 30.6±2.7 months （x2=0.669,P=0.102）,1 a,3 a and 5 a overall survival rates were 87.5%,58.4% and 47.1%,and the tumor free survival rates were 47.1%,58.4% and 47.1%;there were no significant differences as respect to overall survival rates and disease-free survival rates between patients with large liver cancer （5~10 cm） and those with small liver cancer （x2=0.489,P=0.202;x2=1.257,P=0.098）;the overall survival rates and disease-free survival rates in patients with tumor greater than 10 cm were shorter than in with small liver cancer（x2=15.271,P<0.001;x2=8.124,P=0.013）;multivariate analysis showed that serum HBV DNA loads（≥1×104 U/ml） and tumor size（>10 cm） were the independent risk factor for 5 a overall survival rate （OR=1.679,95% confidence interval:0.987~2.341;OR=2.348,P=0.025,95% CI:1.024~4.357,P=0.013） and 5 a disease-free survival rate（OR=2.365,95% CI:2.542~4.368,P=0.013;OR=2.674,95% CI:0.874~1.934,P=0.049）. Conclusion The overall survival and disease-free survival in patients with large liver cancer（5~10 cm） are similar with those in with small liver cancer,while the overall survival and disease-free survival in patients with tumors greater than 10 cm are poor. Measures should be taken to improve the prognosis of patients with large liver cancer.

Key words: Hepatoma, Large liver cancer, Hepatectomy, Survival, Prognosis