Treatment exposure (HR = 2.244; 95% CI: 1.590–3.166; p <  0.001), TNM stage (HR = 2.075; 95% CI: 1.436–3.000; p <  0.001), serum AFP level (HR = 1.819; 95% CI: 1.340–2.469; p = 0.001), tumor size (HR = 1.730; 95% CI: 1.113–2.689; p = 0.015), and ACR (HR = 0.550; 95% CI: 0.392–0.772; p = 0.001) were independent factors for DFS in HCC patients. This evidence concerns the gene AFP and neoplasm.