Abstract: Objective To investigate the factors influencing the overall survival (OS) of patients with hepatocellular carcinoma (HCC) after radical hepatectomy. Methods The clinical data of 1,744 HCC patients who underwent radical hepatectomy in Second Affiliated Hospital of Shandong First Medical University and the Second Hospital of Shandong University were retrospectively collected. The Cox regression proportional hazard model was used to analyze the factors influencing OS, and the survminer package (R language) was used to conduct the forest plots for visual display. Results The 1 -, 3- , and 5- year OS rates of 1,744 HCC patients were 73.5%, 51.0% and 22.2%, respectively. Multivariable Cox regression analysis showed that male (HR=1.242, P=0.026), hepatitis B virus DNA≥500 copies/mL (HR=1.265, P<0.001), alpha-fetoprotein≥400 ng/mL (HR=1.597,P<0.001), Neutrophil to lymphocyte ratio≥3.3 (HR=1.288, P=0.003), BCLC B/C stage (HR=1.734, P<0.001), microvascular invasion (HR=1.548, P<0.001), tumor size ≥5 cm (HR=1.944, P<0.001), and multinodular lesions (HR=1.422, P<0.001) were independent risk factors for OS of HCC patients, while complete tumor capsule (HR=0.673, P<0.001) and postoperative transcatheter arterial chemoembolization (HR=0.652, P<0.001) were independent protective factors. Conclusions The low postoperative OS of HCC patients is the result of multifactorial interaction, including hepatitis B virus DNA ≥500 copies/mL, alpha?fetoprotein ≥400 ng/mL, neutrophil to lymphocyte ratio ≥3.3, BCLC B/C stage, microvascular invasion, tumor size ≥5 cm, and multinodular lesions are independent risk factors and can be used as evaluation indicators for postoperative treatment and prognosis.

Key words: Hepatocellular carcinoma, Prognosis, Influencing factor, Overall survival, Radical hepatectomy