Objective To validate the predictive power of the 5th and 6th editions of TNM staging system（TNM-5

TNM-6） in a Chinese patient cohort with hepatocellular carcinoma（HCC） sized > or = 5 cm after radical hepatectomy.Methods Consecutive 121 patients with HCC sized > or = 5 cm undergoing radical hepatectomy between January 1995 and December 2002 were included.The impact of clinicopathological variables on prognosis was determined by univariate and multivariate analyses

after excluding 2 perioperative deaths.Results In univariate analysis

TNM-5 stage did not show prognostic significance for overall or disease-free survival

as opposed to TNM-6 stage

Edmondson-Steiner grade

portal vein tumor thrombosis（PVTT）

vascular invasion

satellite nodule

Child-Pugh grade

and hepatitis B surface antigen（HBsAg） positivity.When these significant variables were entered in multivariate analysis

Edmondson-Steiner grade was the sole independent prognosticator for both overall and disease-free survival

whereas Child-Pugh grade independently influenced disease-free survival.However

TNM-6 stage lost its predictive potential in multivariate analysis.Conclusions Neither TNM-5 nor TNM-6 staging system is revealed to be independently prognostic in patients with HCC sized > or = 5 cm after radical hepatectomy.Therefore

TNM-6 calls for more support in many subsets of HCC patients.