Studies on the use of serum survivin levels as a diagnostic marker have shown that patients with hepatocellular carcinoma and acute lymphoblastic leukemia have higher serum survivin levels than healthy individuals.[27–30] However, in contrast to these studies, some studies in patients with lung cancer did not show a significant increase in serum survivin levels.[28,66] Since the aim of our study was to examine the relationship between survivin levels, survival, and response to treatment in patients with MPC, survivin was not evaluated as an early diagnosis marker. This evidence concerns the gene BIRC5 and hepatocellular carcinoma.