In the multivariable analysis, age (adjusted HR [aHR] 1.0, 95% confidence interval [CI] 1.0–1.0, P < 0.001), etiology of HBV (aHR 0.8, 95% CI 0.8–0.9, P = 0.001), largest tumor size (aHR 1.5, 95% CI 1.3–1.7, P < 0.001 for tumor size > 5 cm to ≤ 10 cm; aHR 3.2, 95% CI 2.5–4.0, P < 0.001 for tumor size > 10 cm; compared with tumor size ≤ 5 cm as the reference), multiple tumor (aHR 1.3, 95% CI 1.2–1.5, P < 0.001), AFP > 200 ng/mL (aHR 1.4, 95% CI 1.2–1.5, P < 0.001), and ALBI grade 2/3 (aHR 1.7; 95% CI 1.6–1.9; P < 0.001) remained as independent predictors of OS. This evidence concerns the gene AFP and neoplasm.