ROMO1 and metastatic malignant neoplasm in the lymph nodes: With univariate analysis, patients who had no lymph node metastasis (p = 0.002) and lower LNRs (p = 0.011) had better OS, and the high Romo1 group had poorer OS (195.8 vs 158.3 months, p = 0.001) (Fig 3).