Among these, rectal cancer, positive lymph node metastasis, surgical margin (R1 and R2), and low Smurf2 expression were identified as independent poor prognosis factors (P = 0.0019, 0.0265, 0.0410, and 0.0370, respectively; Cox proportional hazards model; Table 2) in multivariate analyses. Here, SMURF2 is linked to metastatic malignant neoplasm in the lymph nodes.