Next, we classified the 257 HCC cases into four groups based on telomere lengths in tumor cells and CAFs. Group I contained cases with longer telomeres in both tumor cells and CAFs; group II included cases with longer telomeres in tumor cells but shorter telomeres in CAFs; group III included cases with shorter telomeres in tumor cells but longer telomeres in CAFs; group IV contained cases with shorter telomeres in both tumor cells and CAFs. Applying Kaplan–Meier analysis, patients in group IV had the shortest OS (median 43.5 months) and TTR (median 41.3 months), whereas patients in group I had the longest OS (median 61.2 months) and TTR (median 54.7 months) (Figure 4E, F). For OS, comparing the four combinations, p < 0.0001; comparing the shorter/shorter combination with the longer/longer combination, p < 0.0001; for TTR, comparing the four combinations, p = 0.019; and comparing the shorter/shorter combination with the longer/longer combination, p = 0.002.