AFP and metastatic malignant neoplasm in the lymph nodes: Shoji and Feng et al. found that liver metastasis was the only independent prognostic factor for APA-GI (6, 31), whereas in other studies, TNM staging, serum AFP level, patient age, peritoneal seeding, lymph node metastasis, vascular invasion, Lauren classification, and AFP IHC results all became independent prognostic factors for APA-GI (29, 32).