Objective To investigate the prognostic factors for transcatheter arterial chemoembolization( TACE) in patients with advanced primary hepatocellular carcinoma( HCC). Methods The clinical data of 124 patients with advanced HCC who were admitted to Huaian No. 1 People's Hospital Affiliated to Nanjing Medical University and underwent TACE from May 2007 to May 2012 were analyzed retrospectively. The Kaplan- Meier method was used to calculated cumulative survival rates,and the log- rank test was used for survival difference analysis and univariate prognostic analysis; the Cox univariate analysis was applied to determine risk factors,and the Cox multivariate stepwise regression analysis was applied to determine independent risk factors. Results Follow- up visits were performed for all patients,and the time for follow- up visits was 3- 40 months. The 0. 5-,1-,2-,and 3- year cumulative survival rates of these patients were97. 6%,74. 2%,15. 5%,and 4. 1%,respectively,with a median survival time of 482 days. Univariate analysis showed that preoperative serum alpha- fetoprotein( AFP) level,tumor size,presence or absence of portal vein tumor thrombus,and tumor stage were the prognostic factors in patients with HCC undergoing TACE( all P < 0. 001); Cox multivariate stepwise regression analysis showed that tumor size,tumor stage,preoperative serum AFP level,and presence or absence of portal vein tumor thrombus were the independent prognostic factors( Wald values = 7. 428,7. 699,15. 235,and 5. 803,respectively,all P < 0. 05). Conclusion Tumor size,tumor stage,preoperative serum AFP level,and presence or absence of portal vein tumor thrombus are the independent prognostic factors in patients with HCC undergoing TACE,and can guide the prognosis and selection of therapeutic regimens in clinical practice.