It has been reported that preoperative serum albumin was associated with operative morbidity and mortality after surgery, including hepatectomy.16,17,33 Previous studies have suggested that lymphopenia and some tools combined with the peripheral lymphocyte count were associated with the prognosis of patients with malignant tumors.18,20,21 Therefore, we hypothesized that the PNI, which combines these parameters, would be a useful predictor of prognosis for patients with HCC. This evidence concerns the gene ALB and hepatocellular carcinoma.