Intriguingly, lymph node metastasis—traditionally a poor prognostic marker—emerged as a protective factor (HR = 0.538, 95% CI: 0.291–0.995, p=0.048), potentially attributable to enriched CD4+/CD8+ memory effector T cells in metastatic lymph nodes (13.3–14.6% higher than non-metastatic nodes), suggesting localized immune microenvironment remodeling may enhance systemic antitumor responses (21). This evidence concerns the gene CD8A and metastatic malignant neoplasm in the lymph nodes.