ObjectiveTo compare three staging systems for predicting the prognosis of patients with advanced hepatocellular carcinoma (HCC) after hepatectomy. MethodsThe clinical data of advanced HCC patients who underwent hepatectomy from January 2004 to December 2008 in this hospital were retrospectively analyzed.Tumor stage was evaluated following the Chinese staging system, tumor node metastasis (TNM) staging system, and cancer of the liver Italian program (CLIP) scoring system, respectively.Survival curves for the HCC patients were plotted using the Kaplan-Meier method and difference was compared by the log-rank test.The accuracy of each staging system for predicting survival of HCC patients was evaluated by calculating the area under curve of the receiver operating characteristic. ResultsFifty-five patients were included in this study, including 48 males and 7 females.The median age was 47 years and the median overall survival was 7 months.The clinical staging of HCC patients was 25 cases ofⅡB and 30 cases ofⅢA using Chinese staging system; 39 cases ofⅢA, 5 cases ofⅢB, 7 cases ofⅣA, and 4 cases ofⅣB using TNM staging system.The score of 0-1 was 16 cases, the score of 2-3 was 26 cases, and the score≥4 was 13 cases using CLIP scoring system.Log-rank test showed that the cumulative survival rate had a significant difference for the HCC patients betweenⅡB andⅢA of Chinese staging system (P < 0.05) and amongⅢA toⅣB of TNM staging system (P < 0.05).However, there was no significant difference in the HCC patients among score of 0-4 of CLIP scoring system (P > 0.05).The accuracy of Chinese staging system was higher than that of the TNM staging system and CLIP scoring system for predicting the survival rate of HCC patients (P > 0.05). ConclusionAccording to this limited preliminary data, Chinese staging system for strati-fying and predicting the prognosis of advanced HCC patients after hepatectomy is better than that of TNM staging system and CLIP scoring system.