An extended right lobectomy with complete resection of the caudate lobe and the retrohepatic vena cava for the treatment of involving primary malignancy of the liver was performed in two 63- and 66-year-old male patients. Vena cava replacement was secured by a 20 mm inner diameter externally stented polytetrafluoroethylene graft. No postoperative complication was observed, and both patients were alive with patent graft and no sign of recurrence, 20 and 2 months after the operation respectively. Seventeen cases of combined hepatic resection and vena cava replacement have been reported. The review of the literature showed that: these challenging hepatectomies have benefited from liver transplantation techniques; patency of prosthetic vena cava replacement is correct; and prolonged survival can be obtained by such extended hepatic resection.