Abstract: Objective To investigate the influence of serum levels of alkaline phosphatase( ALP) and gamma- glutamyltransferase( GGT)before treatment on the prognosis of patients with primary liver cancer undergoing radiofrequency ablation. Methods A total of 165 patients with pathologically or clinically confirmed primary liver cancer who were admitted to Cancer Center of The First Hospital of Jilin University from October 2010 to June 2015 and treated with radiofrequency ablation were enrolled,and their preoperative clinical data were collected.The chi- square test was used for comparison of categorical data between groups,and the Kaplan- Meier method and Cox regression analysis were used to analyze the association of serum ALP and GGT levels before treatment with overall survival,progression- free survival,and clinical features. Results There were significant differences in the 1-,2-,and 5- year survival rates between the patients with normal( ≤135 U/L) or abnormal( > 135 U/L) serum ALP before treatment( 91%/90%/35% vs 79%/68%/18%,P = 0. 01). There were also significant differences in the 1-,2-,and 5- year survival rates between the patients with normal( ≤45 U/L) or abnormal( > 45 U/L)serum GGT before treatment( 95%/85%/37% vs 87%/71%/21%,P < 0. 001). The serum levels of ALP( HR = 1. 766,95% CI: 1. 068- 2. 921,P = 0. 027) and GGT( HR = 2. 312,95% CI: 1. 367- 3. 912,P = 0. 002) before treatment were closely associated with the overall survival of patients with primary liver cancer after radiofrequency ablation and were independent prognostic factors. There were significant differences in the 1-,2-,and 5- year progression- free survival rates between the patients with normal( ≤135 U/L) or abnormal( >135 U/L) serum ALP before treatment( 72%/52%/14% vs 50%/21%/3%,P < 0. 001); there were also significant differences in the 1-,2-,and 5- year progression- free survival rates between the patients with normal( ≤45 U/L) or abnormal( > 45 U/L) serum GGT before treatment( 81%/62%/18% vs 56%/35%/7%,P < 0. 001). The serum levels of ALP( HR = 1. 653,95% CI: 1. 001- 2. 729,P =0. 049) and GGT( HR = 1. 949,95% CI: 1. 296- 2. 930,P = 0. 001) before treatment were closely associated with the progression- free survival of patients with primary liver cancer after radiofrequency ablation. There were more male patients with abnormal ALP than the female patients,and the patients with abnormal ALP had high incidence rates of poor Child- Pugh classification and ascites. In the patients with abnormal GGT( > 45 U/L),there was a high proportion of patients with poor Child- Pugh classification,late tumor stages,and a tumor size of ≥5 cm and a high incidence rate of hepatic encephalopathy. Conclusion The serum levels of ALP and GGT before treatment can be used to predict the prognosis of patients with primary liver cancer after radiofrequency ablation and have certain guiding significance for the long- term survival of patients with primary liver cancer after radiofrequency ablation.