Using four machine learning algorithms to predict LNM in HCC, increasing age (≥60 years), male sex, American Indian, Black, and White race, larger tumor size (3cm ≤ D < 5cm, 5cm ≤ D < 10cm, D ≥ 10cm), advanced T stage (T2, T3, T4), and positive AFP levels were identified as independent risk factors. Here, AFP is linked to hepatocellular carcinoma.