MKI67 and metastatic malignant neoplasm in the lymph nodes: This study, which is to our knowledge the first systematic pathologic analysis focusing on this issue, elucidates that, among resected PanNETs, by applying standardized counting methodology Ki67 index ≥ 10% identifies a significantly more aggressive and a metastasis-prone group and as such supports the evolving management protocols in the oncology literature that advocate managing this group differently.3,7,9,24–35 This category also stood the multivariate analysis along with lymph node metastasis and tumor size/stage.