Abstract: Objective: To discuss the possibility for enhancement of tumor-free and overall survival rates after segmental hepatotectomy. Methods: Data of 175 patients undergoing radical hepatectomy to remove primary large hepatocellular carcinoma (> 5 cm) at our hospital between January 2000 and December 2004 were retrospectively analyzed. The 1, 3 and 5-year tumor-free and overall survival rates of these cases were analyzed, and a comparison was conducted between the patients of the same period with the segmental and nonanatomical hepatectomy. Results: After implementation of the segmental hepatectomy, the 1, 3 and 5-year overall survival rates were 90%, 62.5% and 47.5% and the 1, 3 and 5-year postoperative tumor-free rates were 75%, 50% and 30%, respectively. After nonanatomical hepatectomy, the 1, 3 and 5-year overall survival rates were 90.9%, 65.5% and 49.1% and the 1, 3 and 5-year postoperative tumor-free rates were 80%, 47.3% and 27.3%, respectively. There was no significant difference between the two surgical methods. Conclusion: Although segmental hepatectomy seems to be superior to nonanatomical hepatectomy based on oncological and anatomical theory, it still fails to improve the postoperative tumor-free and overall survival rates in clinical practice. These survival rates might be related to damage of the liver.