Abstract: Objective To study on the differences of 5-year post-operative survival rate of hepatocellular carcinoma (HCC) patients with various serum alpha fetoprotein (AFP) levels prior to the operation. Methods The clinical data of 135 patients who received surgical resection in our hospital from November 2011 to November 2014 were retrospectively analyzed. According to their serum AFP levels before operation, the patients were divided into group A (51 cases, with AFP≤20 ng/mL), group B (36 cases, with 20 ng/mL < AFP≤400 ng/mL) and group C (48 cases, with AFP > 400 ng/mL). Parameters of platelet (PLT), alanine aminotransferase (ALT), gamma glutamyltransferase (GGT), total bilirubin (TBil), albumin (Alb), and prothrombin time (PT) were compared, and the relapse-free survival rate and overall survival rate were analyzed at 1, 3 and 5 years after operation. Results There were no significant differences in PLT, ALT, GGT, TBil, Alb and PT among these three groups (P>0.05). The recurrence free survival rates at 1, 3 and 5 years after operation in group C were 54.2% (26/48), 33.3% (16/48), 27.1% (13/48), respectively, which were significantly lower than 78.4% (40/51), 58.8% (30/51), 41.2% (21/51) in group A, and 69.4% (25/36), 41.7% (15/36), 33.3% (12/36) in group B (P<0.05). The overall postoperative survival rates at 1, 3 and 5 years in group C were 81.3% (39/48), 52.1% (25/48), 35.4% (17/48), respectively, which were significantly lower than 94.1% (48/48), 82.4% (42/51), 62.7% (32/51) in group A, and 91.7% (33/36), 75.0% (27/36), 52.8% (19/36) in group B (P<0.05). Conclusion Preoperative serum AFP levels are closely associated with the prognosis of HCC.

Key words: Alpha fetoprotein, Hepatocellular carcinoma, Hepatectomy, Survival rates