AFP and neoplasm: Consistent with these findings, our study demonstrates that elevated serum AFP levels are significantly associated with both SLT failure (OR 2.14, 95% CI 1.03–4.47, p = 0.042) and poorer survival outcomes (HR 2.68, 95% CI 1.62–4.44, p < 0.001), reinforcing the pivotal role of tumour biology in shaping HCC treatment strategies.