In multivariate analysis, lymph node metastases (HR 2.03, p = 0.0186) in primary tumors and grade B.C (HR 2.21, p = 0.0057) and high HIF-1α expression (HR 2.40, p = 0.0079) in metastatic tumors were independent recurrent factors (Table 4). Here, HIF1A is linked to metastatic neoplasm.