The optimal LNR that can be used as a prognostic tool remains to be determined by larger and prospective studies that include data on grade, KI67% status, stage, pathologic information about lymph vascular and perineural invasion, necrosis, tumor size, and uniform approach in terms of assessment, surgical treatment, follow-up, and pharmacological intervention that may determine LNR ratio that is adjusted to all the mentioned confounders. Here, MKI67 is linked to neoplasm.