AIM To determine the clinical presentations,survival and prognostic factors of hepatocellularcarcinoma(HCC)in Southern Thailand.METHODS Retrospective analysis wasperformed on the 336 hepatocellular carcinomapatients treated at Songklanagarind hospitalbetween 1 January 1991 and 31 January 1999.RESULTS Of these 336 patients,276 weremales and 60 were females.The mean age was54.4 years.The common symptoms and signswere abdominal pain and hepatomegaly.Themost common presentation of tumor was adominant mass with daughter nodules.Portalvein involvement was found in 50% of total.Extrahepatic metastasis was found in 13%,andthe lung was the most common site.There were55.4% with evidence of cirrhosis and half ofthem were in Childs class B.HBsAg waspositive in 72.6%.Regarding Okuda’s tumorstaging,15%,61% and 24% were stage Ⅰ,Ⅱand Ⅲ,respectively.Overall median survivalwas 2.1 months(11.5,2.6 and 0.7 months forstage Ⅰ,Ⅱ and Ⅲ respectively).Treatments ofHCC improved patient survival(5.5 months vs1.6 months for untreated patients ).Mostcommon causes of death were hepatic failure.Using multivariate analysis,the prognostic factors identified were tumor staging,alpha-fetoprotein level above 10000μg·L~(-1)extrahepatic metastasis,portal vein thrombosisand treatment.CONCLUSION HCC in Thailand is a fataldisease with poor outcome due to latepresentation and high prevalence of livercirrhosis.Early detection and propermanagement may improve outcome. AIM To determine the clinical presentations, survival and prognostic factors of hepatocellular carcinoma (HCC) in Southern Thailand. METHODS Retrospective analysis was formed on the 336 hepatocellular carcinomapatients treated at Songklanagarind hospital between 1 January 1991 and 31 January 1999 .RESULTS Of these 336 patients, 276 were males and 60 were females. The mean age was 54.4 years. The common symptoms and signswere abdominal pain and hepatomegaly.Themost common presentation of tumor was adominant mass with daughter nodules .Portalvein involvement was found in 50% of total .Extrahepatic metastasis was found in 13 %, and the lung was the most common site. There were 55.4% with evidence of cirrhosis and half of the were were in Childs class B. HBsAg waspositive in 72.6% .Regarding Okuda’s tumorstaging, 15%, 61% and 24% were stage I, ⅡandⅢ, respectively.Overall median survivalwas 2.1 months (11.5, 2.6 and 0.7 months forstage Ⅰ, Ⅱ and Ⅲ respectively) .Treatments ofHCC improved patient survival (5.5 m onths vs 1.6 months for untreated patients) .Mostcommon causes of death were hepatic failure. Using multivariate analysis, the prognostic factors identified were tumor staging, alpha-fetoprotein level above 10000 μg · L -1 extrahepatic metastasis, portal vein thrombosis and treatment .CONCLUSION HCC in Thailand is a fatal disease with poor outcome due to late presentation and high prevalence of liver cirrhosis. Early detection and proper management may improve outcome.