Some studies reported no association between CD44 levels and LN status, recurrence, distant metastasis, or pathological response to treatment.[11–13] Some studies found that high expression of CD44 was associated with aggressive tumor-related features and decreased survival rates.[14] Conversely, CD44 expression was reported as decreased in patients with LN metastasis.[15] Similar to the former studies, the expression level was significantly higher in patients with high-stage tumors, LN metastasis, and distant metastasis in our study. Here, CD44 is linked to neoplasm.