Introduction
Squamous cell carcinoma (SCC) represent 90% of head and neck cancers (HNC), which is the fifth most common cancer worldwide. Oral and oropharyngeal squamous cell carcinoma (OOSCC) accounts for respectively 30% and 20% of HNC(1).
Histological prognostic factors are widely acknowledged currently and constitute an integral part of the therapeutic strategy. However, they are only obtainable after pathological examination of the entire resected specimen. Indeed, small sizes of preoperative biopsy samples may not allow assessment of the tumor differentiation degree, and may not accurately represent the nature of the entire tumor(2). It is therefore not currently possible to determine histological prognostic factors preoperatively nor for patients who do not benefit from a surgical treatment.
CT texture analysis (CT-TA) has been reported to be a useful tool for preoperatively assessing survival in various types of cancers, such as oesophageal, colorectal, non-small cell lung cancers, hepatocellular carcinoma, metastatic melanoma and also to predict treatment response(3,4). CT-TA can indeed overcome the drawbacks related to visual analysis of tumor heterogeneity and quantify the heterogeneity reflecting spatial differences in tumor perfusion and proliferation(5).
In locally advanced head and neck squamous cell carcinoma (HNSCC), a recent study has reported the potential prognostic value of tumor texture features on overall survival(6).
The purpose of this retrospective study was to determine if contrast-enhanced CT- based texture analysis could constitute a new biomarker of overall survival (OS) and event-free survival (EFS) in patients suffering from OOSCC treated by surgical resection