HOXA1 and metastatic malignant neoplasm in the lymph nodes: We do not feel that HOXA1 was sufficiently studied in its role in tumor prognosis in OSCC or other malignancies, however, several studies have reported that lymph node metastasis is the most reliable marker of OSCC patient prognosis [28-30], and our findings showed that the presence of lymph node metastasis significantly correlated with high HOXA1 expression and both were significant prognostic factors for overall survival by multivariate analysis.