Abstract:Hepatocellular carcinoma (HCC), a leading cause of cancer-related mortality worldwide, demonstrates marked heterogeneity in biological behavior and therapeutic response. Emerging evidence indicates that tumor capsule integrity, a classical histopathological feature, plays a pivotal role in risk stratification and treatment decision-making. Preoperative assessment primarily relies on imaging modalities, whereas histopathology remains the gold standard. According to structural integrity, the capsule can be categorized as complete, incomplete, or absent. An intact capsule functions as a physical barrier that limits tumor invasion and is closely associated with a lower incidence of microvascular invasion. In surgical management, narrow-margin resection may be considered in capsule-intact tumors when negative margins are secured, whereas wider margins are recommended for tumors with incomplete or absent capsules. Beyond surgery, capsule integrity has been correlated with therapeutic response to transarterial chemoembolization, radiotherapy, and systemic therapies, potentially through mechanisms involving tumor hemodynamics, microenvironmental modulation, and oncogenic signaling pathways as a bridge linking tumor biology with therapeutic strategies. Tumor capsule status warrants further investigation in the era of precision medicine.