After controlling for gender; age; T stage, N stage, M stage, and AJCC stage; adjuvant chemotherapy (ACT); tumor mutation burden (TMB); neoantigen; and TP53, KRAS, BRAF, and PIK3CA mutations, MSSAS remained statistically significant for predicting the OS in the three cohorts, which suggested that MSSAS was an independent risk factor for the OS (Figures 4A–C). Here, PIK3CA is linked to neoplasm.