Multivariate analysis showed that pathological lymph node metastasis was the poorest prognostic factor (HR, 2.19; 95% CI, 1.36–3.66; P=0.0010), followed by NAC (HR, 1.88; 95% CI, 1.24–2.86; P=0.0028), histology (HR, 1.87; 95% CI, 1.13–3.49; P=0.014), and IMP3 expression (HR, 1.84; 95% CI, 1.18–2.93; P=0.0064) (Table III). This evidence concerns the gene IMP3 and metastatic malignant neoplasm in the lymph nodes.