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Biopsy is recommended only in case of inconsistent results, e.g., small nodules lacking a typical arterial-phase hypervascularization perfusion and/or a venous-phase washout signal. Moreover, microvascular invasion and tumor stage were identified as major risk factors for HCC recurrence [13]. Of note, only 1 of 27 (4%) patients fulfilling the Milan criteria compared with 15 of 33 (45%) patients exceeding the Milan criteria developed http://www.selleckchem.com/products/bmn-673.html recurrent HCC (P? http://www.selleckchem.com/products/cobimetinib-gdc-0973-rg7420.html showed no difference, although the survival curves were apparently slightly higher for patients inside the Milan criteria [10]. All clinical staging systems are limited because the tumor biology in a given patient cannot be determined confidently, and therefore the individual prognosis at the time of the initial diagnosis remains uncertain [18�C21]. According to the Barcelona Clinic Liver Cancer (BCLC) approach, resection is the treatment of choice in patients with limited tumor size and normal bilirubin levels as well as absence of portal hypertension [22]. In these patients, rescue OLT is feasible in case of recurrent or de novo liver cancer fulfilling the Milan criteria [23]. In contrast, in patients with (very) early stage HCC, but impaired liver function, OLT http://www.selleck.cn/products/incb024360.html is recommended as primary treatment approach [24]. Repeated transarterial chemoembolization (TACE), as a bridging therapy for patients awaiting a liver transplantation with impaired liver function or resection in those patients without impaired liver function, might contribute to selection of patients with biologically less aggressive tumors and therefore to further reduction in HCC recurrence rates after OLT [25]. To overcome the weak correlation between tumor stage and biological behavior of HCC [18�C21], molecular profiling by high-throughput technologies is currently investigated [26�C28]. In a training set of 89 HCC patients with HCV-related liver cirrhosis, who were treated with liver transplantation or liver resection, three major micro RNA (miRNA) clusters were identified.