# Decoding Temporal Bone Carcinoma: The Role of CT and MRI in Precision Staging
## 3 Results
In both cases of cervical metastasis, preoperative CT had suggested regional disease. \begin{table}
\begin{tabular}{c c c c c} \hline \hline \multirow{2}{*}{**Patient No.**} & **Radiological** & **Pathological** & **Clinical** & **Follow-Up** \\  & **Staging** & **Staging** & **Outcome** & **(months)** \\ \hline
1 & T1N0 & pT1N0 & NED & 28 \\
2 & T1N0 & pT1N0 & NED & 119 \\
3 & T2N0 & pT2N0 & NED & 95 \\
4 & T1N0 & pT1N0 & LTF & 5 \\
5 & T2N0 & pT1N0 & NED & 27 \\
6 & T1N0 & pT2N0 & NED & 87 \\
7 & T3N0 & pT3N0 & NED & 33 \\
8 & T2N0 & pT2N0 & LTF & 15 \\
9 & T3N0 & pT2N0 & NED & 89 \\
10 & T3N0 & pT3N0 & DOD & 6 \\
11 & T3N2b & pT3N2b & DOD & 8 \\
12 & T1N0 & pT3N0 & DOD & 6 \\
13 & T4N0 & pT4N0 & DOD & 5 \\
14 & T4N1 & pT4N1 & DOD & 1 \\
15 & T4N0 & pT4N0 & DOD & 1 \\ \hline \hline \end{tabular} Legend: NED (no-evidence of disease), LTF (lost to follow-up), and DOD (death due to disease).  
\end{table} 
Table 2: Clinical summary of patients with temporal squamous cell carcinoma. \begin{table}
\begin{tabular}{c c c} \hline \hline \multicolumn{1}{c}{**Patient No.**} & **Radiological Staging** & **Pathological Staging** \\ \hline
5 & T2N0 (bone erosion) & pT1N0 (no bone erosion) \\
6 & T1N0 (no bone erosion) & pT2N0 (bone erosion) \\
9 & T3N0 (opacified mastoid) & pT2N0 (free mastoid) \\
12 & T1N0 (no bone erosion) & pT3N0 (invasion of the TMJ) \\ \hline \hline \end{tabular} Legend: TMJ (temporo-mandibular joint).  
\end{table} 
Table 3: Discrepancy between radiological and pathological staging. A multifactorial comparison of potential prognostic factors was performed on the 13 patients who either died due to disease or showed no evidence of disease after 2 years of follow-up. The remaining 2 patients were excluded from the analysis due to insufficient follow-up. The clinical outcome of patients was largely dependent on the extent of local disease, reflected in the severity of presenting symptoms, the stage of the primary tumor, and the extent of surgical resection. Statistical analysis using [PERSON]'s exact test revealed that certain prognostic factors were significantly associated with an unfavorable clinical outcome. In particular, \(p\)-values \(<0.05\) were obtained for the T3-T4 tumor stage (\(p=0.004\)), subtotal resection (\(p=0.02\)), facial nerve sacrifice (\(p=0.03\)), positive surgical margin (\(p=0.02\)), and postoperative radiotherapy (\(p=0.02\)), suggesting that these factors are significantly associated with an increased likelihood of death due to disease (DOD). Figure 1: Axial MRI of the temporalis (**a**) in patients with SCC of the left EAC. The disease was classified as T1 by imaging, (**b**) but the final pathologic findings showed that it was T2 with bone erosion. The text continues here (Figure 2 and Table 2). Figure 2: (**a**) Axial CT and (**b**) Axial MRI: Tissue occupies the acoustic meatus with the expansion of the auricular and condylar base without apparent erosive phenomena. Diagnosis of keratinizing squamous cell carcinoma and figure-free lymph node referable to metastasis. Legend: SCC (squamous cell carcinoma), EAC (external auditory canal), CT (computed tomography), and MRI (magnetic resonance imaging). These findings imply that factors related to tumor aggressiveness (T3-T4) and the type of intervention performed (subtotal resection, facial nerve sacrifice, postoperative radiotherapy) play a crucial role in prognosis and should be considered when identifying patients at risk of negative clinical outcomes, thus guiding therapeutic decision-making.