30+ years of experience
500+ CRS+HIPEC procedures
International multidisciplinary committee
Reviewed by Dr Juan José Torrent · Updated: 4 September 2026

Surgery

CC score

Completeness of Cytoreduction

Scale that measures how much tumour remains at the end of cytoreductive surgery: CC-0 (no visible residue), CC-1 (nodules smaller than 2.5 mm), CC-2 and CC-3 (larger residue). Achieving CC-0 or CC-1 is the single most important prognostic factor.

The 2.5 mm cut-off is not arbitrary: it is roughly the depth to which intraperitoneal chemotherapy penetrates tissue. Below that measurement HIPEC can still act on the residue; above it, it does not reach it.

That is why CC-0 and CC-1 are considered complete cytoreduction for treatment purposes, and CC-2 and CC-3 incomplete.

It should not be confused with the R0, R1 or R2 margin, which describes whether the pathologist finds tumour at the edges of one specific specimen. The CC score assesses the whole abdomen at the end of the operation; the R margin, a single resection.

This explanation is intended as general information and does not replace a specialist assessment of an individual case.

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