ABSTRACT. We conducted a cohort study to investigate the prognostic significance of vascular endothelial growth factor (VEGF) polymorphisms in hepatocellular carcinoma (HCC) patients after transcatheter arterial chemoembolization (TACE). In total, 156 patients with histologically confirmed HCC within 2 months were collected from January 2007 to January 2008. The genotypes of VEGF-2578C/A, -1154G/A, -634C/G, and -1498T/C were determined from blood extracted using a blood kit on a 384-well plate. The survival rate at 5 years was 55.47%. Multivariate analysis revealed that only tumornode-metastasis (TNM) stage, metastasis, and the VEGF-2578 AA and -1154 AA genotypes were independent prognostic factors. Patients with TNM stage III-IV and metastasis showed a greatly increased risk of death from HCC, with hazard ratios (HRs) [95% confidence interval (CI)] of 3.64 (1.67-6.79) and 2.91 (1.30-6.27), respectively. Moreover, the VEGF-2578 AA and -1154 AA genotypes showed a significantly increased risk of death compared with the wild-type genotype (HR 8947 ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 13 (4): 8946-8953 (2014) VEGF polymorphism and HCC prognosis = 3.65, 95%CI = 1.35-11.13; HR = 7.13, 95%CI = 1.46-65.8). These results will be helpful for predicting clinical outcomes of HCC patients.