To evaluate the application of hepatic resection (HR) for patients with Stage IV hepatocellular carcinoma (HCC), we compared the back-ground factors and survivals after therapies between Stage IV HCC patients who underwent HR (n = 38) and those who received arterial embolization (n = 186, group C). Of the patients who had HR, 17 (45.1) had relative noncurative (RN) resection (group A) and the remaining 21 (55%) had absolute noncurative (AN) resection (group B). Back-ground factors in relation to liver function were significantly better in both A and B than in C. On the other hand, tumor-relating factors were better in A than in both B and C, and were worse in B than in C. Five-year survival rates of group A and group C were 37.1 and 13.1 respectively (A to C; p < 0.05) and there were no longer survivors than two years in group B. These results suggested that the group which had better back-ground factors gained the better prognosis. To compare the survivals in the patients having well back-ground factors who were dominant in group A, the patients whose clinical stage was I or the number of tumors was two or less were selected from each group. Among these selected patients, the survivals of group A were significantly better than those of the other groups.