Forward stepwise multivariate Cox analysis determined that tumor differentiation (P = 0.001; hazard ratio [HR], moderate: 2.368, 95% CI: 1.120-5.007; HR, poor: 6.603, 95% CI: 2.515-17.338), serum CA19-9 (P = 0.021; HR: 1.914, 95% CI: 1.105-3.318), and MUC4 expression (P = 0.001; HR: 2.281, 95% CI: 1.415-3.677) were significant independent risk factors. Here, MUC4 is linked to neoplasm.