The multivariate analysis (Likelihood ratio forward method), using the above clinical parameters, indicated that tumor size (HR = 1.973; 95% CI: 1.230–3.164; p = 0.005), TNM stage (HR = 0.470; 95% CI: 0.319–2.504; p <  0.001), treatment exposure (HR = 2.191; 95% CI: 1.533–3.132; p <  0.001), serum AFP level (HR = 1.752; 95% CI: 1.277–2.403; p = 0.001), and ACR (HR = 0.544; 95% CI: 0.385–0.769; p = 0.001) were independent and significant prognostic factors in HCC patients. Here, AFP is linked to hepatocellular carcinoma.