Key points:
  1. Histological criteria of poor prognosis cannot be used pre-operatively in oral cavity and oropharyngeal squamous cell carcinoma (OOSCC) because a biopsy does not reflect all of the tumor heterogeneity
  2. Image texture parameters analyzed on pre-operative contrast-enhanced computed tomography (CT) imaging could reflect tumor heterogeneity and could be associated with overall survival and event-free survival in these patients.
  3. Texture parameters were evaluated: mean gray-level, standard deviation, kurtosis, skewness and entropy.
  4. Mean gray-level of the histogram was significantly associated with overall survival at spatial scale filtration (SFF) 5 and with event-free survival at coarse scale (SSF) 6.
  5. Pretreatment CT scan texture analysis mean gray-level may be associated with survival in patients with OOSCC.
Key words: Squamous cell carcinoma, Oral cavity, Oropharynx, Computer-assisted image analysis, Survival