Background: Prognosis of patients with advanced HCC is very poor, median overall survival varies from 3 to 6 months. Life expectancy more than 3 months is one inclusion criteria for molecular targeted drugs in clinical tirals. There exists four models for end-stage liver disease: 1.) MELD: The model for end-stage Liver disease; 2.) MELD-AS: MELD+4.53×c(Na)+4.46×Ascites [Serum Na: Na<135 mmol/L score 1, otherwise score 0; Ascites: persistent ascites score 1, otherwise score 0]; 3.) iMELD: MELD+(0.3×age)-0.7×c(Na)mmol/L+100; 4.) MESO:[MELD/c(Na)mmol/L]×10.Now we want to compare four models in predicting the survival rate of advanced HCC patients. Methods: From September 2008 to September 2010, a total of 183 patients with advanced HCC who were not amendable to locoregional therapy were analyzed. The median survival was 6.6 months. Data were collected to classify patients according to MELD, MELD-AS, iMELD and MESO at diagnosis.3-month survival and 6-month survival were the end points used in the analysis. Results: When predicting 3-month survival, ROC analysis shows AUC of MELD-AS, MESO, MELD and iMELD is 0.718, 0.691, 0.688 and 0.620. AUC of MELD-AS is significantly higher than that of the other three models (p<0.05 ).Cut-off point of MELD-AS is 9.54 with 76.9% sensitivity and 59.5% specificity.The cut-off point of MESO, MELD and iMELD is 0.44, 6.19 and 23.87. When predicting 6-month survival, ROC analysis shows AUC of MELD-AS, MESO, MELD and iMELD and is 0.574, 0.538, 0.533 and 0.507. AUC of MELD-AS is significantly higher than that of the other three models (p<0.05 ).Cut-off point of MELD-AS is 18.53 with 27.7% sensitivity and 89.1% specificity.The cut-off point of MESO, MELD and iMELD is 1.04, 13.83 and 40.76. MELD-AS, MESO, MELD and iMELD is dichotomized according to the cut-off point generated by ROC analysis when predicting 6-month survival.Log-Rank test shows P value of MELD-AS, MESO, MELD and iMELD is 0.001,0.008,0.02 and 0.0009 respectively. Conclusions: MELD-AS is the best model in prediction of 3-month survival and 6-month survival among the four models for end-stage liver disease analyzed for Chinese advanced HCC patients.