Background and Aims Hepatocellular carcinoma (HCC) has an insidious onset and high mortality. Tumor makers have great importance in early detection, prognostic estimation and efficacy monitoring. Studies have demonstrated that inflammatory indices are closely associated with the prognosis of HCC. Therefore, this study was conducted to investigate the relations of preoperative integrated inflammatory marker alkaline phosphatase to albumin ratio (AAR) and gamma-glutamyl transpeptidase to platelet ratio (GPR) with the postoperative prognosis of HCC.Methods The clinical data of 347 eligible HCC patients undergoing hepatectomy in the Department of Hepatobiliary Surgery of Xijing Hospital from January 2014 to December 2017 were retrospectively analyzed. The patients were randomly divided into training set (243 cases) and validation set (104 cases) in a ratio of 7∶3 by a random number generator. The optimal cutoff values of AAR and GPR were obtained by the X-tile software according to the survival data in training set. The associations of AAR, GPR and their combination index (AAR-GPR) as well as other clinicopathologic variables with the survival of patients were analyzed in training set and validation set, respectively. The differences in survival rates among patients with different AAR or GPR values or different AAR-GPR scores (those with both AAR and GPR above the cutoff values were defined as 2, and the remaining conditions were classified as 1) were compared in training set and validation set, respectively. The prognostic prediction values among AAR, GPR and AAR-GPR were compared by analysis of R3.2 software.Results The median follow-up time of the 347 patients was 45 months. A total of 147 patients died, and the cumulative 1-, 3- and 5-year survival rates were 84.6%, 59.4% and 52.2%, respectively. There were no statistically significant differences (P>0.05) between training set and validation set except for AJCC stage (χ²=6.21，P=0.045). The optimal cutoff value for AAR was 2.61 and for GPR was 0.39. Results of analyses in both training and validation sets showed that AAR (training set: HR=1.904, P=0.003; validation set: HR=2.245, P=0.008), GPR (training set: HR=2.159, P=0.002; validation set: HR=2.646, P=0.006) and AAR-GPR (training set: HR=2.872, P<0.001; validation set: HR=4.643, P<0.001) were independent risk factors for postoperative survival. The prognostic prediction value of AAR-GPR (C-index: 0.831, likelihood ratio: 24.36) was superior to that of either AAR (C-index: 0.765, likelihood ratio: 12.11) or GPR (C-index: 0.772, likelihood ratio: 13.43) alone.Conclusion Both AAR and GPR are independent risk factors for survival after HCC resection. Compared with AAR or GPR alone, their combination index can significantly improve the predictive efficiency and predict postoperative survival more accurately. Since this is a single-center study, further validation is still needed by large-sample size and multi-center high-quality studies.