Ferrer-Fàbrega J, Sampson-Dávila J, Forner A, et al. - Since defining optimum management of patients progressing beyond Milan criteria on the waiting list is a contentious issue, experts aspired to explore whether the policy of allowing a limited progression beyond enlistment criteria permits acceptable outcomes in terms of survival and recurrence. Between January 1989 and December 2016, patients with hepatocellular carcinoma included on the waiting list for liver transplantation were analyzed. In total, 495 patients constituted the target population. Although limited tumour progression without reaching major adverse predictors (vascular invasion, extrahepatic spread, cancer symptoms) has an expected impact on recurrence rate, overall survival remains above the minimum proposed benchmark of 65% at five years. When analyzing the benefit of this approach in the case of a limited organ supply, the clinically relevant increase in tumour recurrence must be taken into account.