EFEMP2 and metastatic malignant neoplasm in the lymph nodes: In multivariate analysis, considering all histological and molecular features together, the important prognostic factors were fibulin-4 expression (P = 0.000; hazard ratio 2.129), lymph node metastasis (P = 0.001; hazard ratio 1.017), and tumor stage (P = 0.005; hazard ratio 1.984) (Table 3).