There was the objective to improve the results of treatment in patients, suffering hepatocellular carcinoma (HCC) with vena cava invasion by the tumor. In the main group a hepatic resection with the portal vein resection and portoplasty was performed in 21 patients, suffering HCC with vena cava invasion by the tumor of second-third degree (according to J. Shi, 2007); in a control group in 61 patients, suffering the portal vein tumoral invasion of first degree, the hepatic resection only was done. The mortality have constituted 9.5% in the main group and 8.1%--in a control one. The 5-year survival index have constituted 11.5%--in the main group and 25.3%--in a control one. The aggressive surgical tactics application for HCC with portal vein tumoral invasion permits to enhance the indices of the patients far-remote survival.