After adjusting for confounders, age ≥ 60 years (hazard ratio [HR], 1.454; 95% CI, 1.154–1.832; P = 0.002), hepatitis B virus infection (HR, 0.542; 95% CI, 0.416–0.705; P < 0.001), platelet count < 100 k/mm3 (HR, 1.452; 95% CI, 1.149–1.834; P = 0.002), AFP > 200 ng/mL (HR, 1.430; 95% CI, 1.095–1.867; P = 0.009), HCC size ≥ 2 cm (HR, 1.420; 95% CI, 1.141–1.766; P = 0.002), and initial curative treatment (HR, 0.448; 95% CI, 0.357–0.564; P < 0.001) were independently associated with survival in patients with single-nodular HCC detected during surveillance. Here, AFP is linked to hepatocellular carcinoma.