After adjusted for other confounding factors, ALDH2 “GG” genotype (P = 0.019), microvascular invasion (P < 0.001), macrovascular invasion (P = 0.006), larger tumor size (P = 0.017), and higher AFP (P = 0.003) remained as independent predictors for a shorter time-to-distant metastasis. Here, AFP is linked to neoplasm.