a trend toward significancep = 0.055
In multivariable analysis, metastatic recurrence was the strongest independent predictor of death (HR 37.1; 95% CI 7.29–189; p < 0.001), local recurrence showed a trend toward significance (HR 0.26; 95% CI 0.07–1.03; p = 0.055), and status at last follow-up remained highly predictive of survival (HR 0.01; 95% CI 0.00–0.04; p < 0.001).