The 5-year survival rate for patients with stage III, stage IVA with low AST/ALT, stage IVA with high AST/ALT, and stage IVB were 64.8%, 49.2%, 28.6%, and 33.3%, respectively (p < 0.001). Compared with stage IVA with low AST/ALT group, HRs (adjusted for age, site and treatment modality) were 0.71 (95%CI: 0.40–1.20 p = 0.204), 2.17 (95%CI: 1.02–4.22 p = 0.045), and 2.64 (95%CI: 1.06–5.66 p = 0.038) for stage III, stage IVA with high AST/ALT, and stage IVB groups, respectively (Table 4).