borderline significanceP =0.051
Multivariate analysis confirmed signet ring histology (HR 6.00, 95% CI 1.32–27.22, P =0.020) and advanced pathological stage (HR 13.28, 95% CI 2.76–63.89, P =0.001) as independent adverse prognostic factors, whereas lymph node ratio demonstrated borderline significance (HR 35.77, 95% CI 0.98–1308.06, P =0.051).