BACKGROUND:?Hepatic? resection? is? the? main? treatment?modality?for?hepatic?tumors.?Advances?in?diagnostic?technique,?preoperative?preparation,?surgical?technique,?and?postoperative?management? increased? the? success? rate.? The? present? study?aimed?to?evaluate?hepatectomy?and?resection?of?inferior?vena?cava?tumor?thrombus?(IVCTT)?in?patients?with?hepatocellular?carcinoma,?and?the?relationship?between?IVCTT?classification?and?selection?of?surgical?technique. METHODS:?We? retrospectively? reviewed? 13? patients? with?hepatocellular? carcinoma? who? had? undergone? hepatectomy?with?IVCTT?resection?between?May?1997?and?August?2009.?Age,?gender,? diagnosis,? findings? of? physical? examination,? results? of?preoperative?laboratory?investigations,?radiological?examination,?criteria?for?resection,?postoperative?pathological?results,?incisions,?operative? technique,? intraoperative? transfusion,? drains,? and?intraoperative? and? postoperative? complications? were? evaluated?for?all?patients. RESULTS:?Type?I?IVCTT?(10?patients)?was?posterior?to?the?liver?and?below?the?diaphragm;?type?II?IVCTT?(2?patients)?was?above?the?diaphragm?but?still?outside?the?atrium;?and?type?III?IVCTT?(1?patient)?was?above?the?diaphragm?and?in?the?right?atrium.?Type?I? was? treated? by? radical? hepatectomy? and? removal? of? IVCTT?with? total? hepatic? vascular? exclusion.? Type? II? was? treated? by?radical?hepatectomy?and?removal?of?IVCTT?by?incision?of?the?diaphragm.?Type?III?was?treated?by?hepatectomy?and?resection?of?the?thrombus?from?the?right?atrium?under?cardiopulmonary?bypass.?There?were?no?surgical?complications?and?one?patient?has? been? survived? for? 4? years? with? cancer-free? status.? The?median?survival?time?was?18.2?months,?and?the?1-?and?2-year?survival?rates?were?53.8%?and?15.4%,?respectively. CONCLUSION:?Surgical? treatment? is? safe? and? feasible? for?treatment?of?IVCTT?in?patients?with?hepatocellular?carcinoma,?and? surgical? resectability? can? be? judged? according? to? the?classification?of?tumor?thrombus.