Recent advancements in radiomics have significantly enhanced the predictive capabilities for meningioma, particularly regarding brain invasion. A study by Joo et al. developed a random forest classifier model that integrates peritumoral edema volume and specific MRI features to predict brain invasion, demonstrating improved diagnostic performance over traditional clinical parameters (ref: Joo doi.org/10.1093/neuonc/). Similarly, Zhang et al. constructed a nomogram that combines radiomic signatures with clinical features to predict brain invasion preoperatively, emphasizing the importance of early intervention in surgical planning (ref: Zhang doi.org/10.1016/j.ebiom.2020.102933/). These studies collectively highlight the potential of imaging-based models in refining surgical strategies and prognostic assessments in meningioma management. Furthermore, Lorenz et al. introduced a comprehensive DNA panel next-generation sequencing approach that supports diagnostics and therapy prediction, underscoring the growing intersection of molecular genetics and imaging in neurooncology (ref: Lorenz doi.org/10.1186/s40478-020-01000-w/). The integration of imaging and genetic profiling could lead to more personalized treatment approaches, although challenges remain in standardizing these methodologies across clinical settings. Additionally, Dobra et al. explored the utility of small extracellular vesicles as biomarkers for monitoring CNS tumors, indicating a shift towards liquid biopsy techniques in the management of meningiomas (ref: Dobra doi.org/10.3390/ijms21155359/).

The genetic landscape of meningiomas has been further elucidated through various studies focusing on mutations and genomic profiles. Maier et al. investigated TERT promoter mutations in WHO grade III meningiomas, finding a significant prevalence of these mutations in malignant cases, which could serve as a potential biomarker for aggressive disease (ref: Maier doi.org/10.1111/bpa.12892/). In parallel, Kim et al. characterized genomic profiles of primary cancer cell lines derived from atypical meningiomas, providing insights into the biological behavior of these tumors and the need for better preclinical models (ref: Kim doi.org/10.1186/s12935-020-01438-x/). Wanner et al. highlighted geographical variations in tumor incidence, suggesting that environmental and genetic factors may influence meningioma development, with higher rates observed in high-income countries compared to middle-income regions (ref: Wanner doi.org/10.1007/s11060-020-03595-5/). Additionally, Wang et al. identified a transcription factor-microRNA-gene coregulation network in meningioma through bioinformatics analysis, which may provide new therapeutic targets (ref: Wang doi.org/10.1155/2020/). Nagaishi et al. examined HMGA2 expression in meningiomas, finding no significant correlation with clinical features, which raises questions about its role in tumor progression (ref: Nagaishi doi.org/10.1111/neup.12670/). Collectively, these studies underscore the complexity of meningioma genetics and the potential for targeted therapies based on molecular profiling.

Surgical techniques for meningioma resection have evolved, with a focus on minimizing invasiveness while maximizing outcomes. Caballero-García et al. evaluated a minimally invasive 360-degree endoscopic approach for orbital tumors, reporting promising results in terms of safety and efficacy, particularly in patients with visual loss and proptosis (ref: Caballero-García doi.org/10.1016/j.ajo.2020.07.035/). This technique exemplifies the trend towards less invasive methods that can reduce recovery time and complications. In a broader context, Nassiri et al. conducted a survey to understand the patient experience post-surgery, revealing significant gaps in care and the need for improved symptom management strategies (ref: Nassiri doi.org/10.1093/noajnl/). Chen et al. introduced a prognostic gene-expression signature that outperformed traditional WHO grading in predicting recurrence, suggesting that molecular markers could guide postoperative management (ref: Chen doi.org/10.1093/neuros/). Brokinkel et al. revisited the Simpson grading system, advocating for a refined approach to assess the extent of resection and its correlation with recurrence rates, thus enhancing surgical decision-making (ref: Brokinkel doi.org/10.1007/s10143-020-01369-1/). Ansari et al. presented modifications to the supraorbital eyebrow craniotomy technique, which improved postoperative outcomes, indicating that surgical innovation continues to play a critical role in meningioma management (ref: Ansari doi.org/10.1093/ons/).

Understanding prognostic factors in meningioma is crucial for optimizing patient management and predicting outcomes. Chen et al. developed a gene-expression risk score that significantly correlated with local freedom from recurrence and overall survival, outperforming traditional WHO grading in stratifying patients (ref: Chen doi.org/10.1093/neuros/). Ueberschaer et al. highlighted the limitations of intraoperative assessments of resection extent, demonstrating discrepancies between Simpson grading and postoperative imaging, which could lead to false negatives in tumor remnant detection (ref: Ueberschaer doi.org/10.1093/neuros/). Zamanipoor Najafabadi et al. assessed long-term health-related quality of life in meningioma patients, revealing persistent neurocognitive deficits and quality of life impairments, emphasizing the need for comprehensive follow-up care (ref: Zamanipoor Najafabadi doi.org/10.1093/neuros/). Garcia-Segura et al. identified necrosis and brain invasion as predictors of radio-resistance and recurrence in atypical meningiomas, suggesting that these factors should be considered when planning adjuvant therapies (ref: Garcia-Segura doi.org/10.1093/neuros/). Brokinkel et al. further reinforced the importance of refining surgical grading systems to better predict recurrence, advocating for a more nuanced approach to postoperative surveillance (ref: Brokinkel doi.org/10.1007/s10143-020-01369-1/).

The quality of life and patient experiences following meningioma treatment are critical areas of research that inform care practices. Nassiri et al. conducted a comprehensive survey involving 1852 patients, identifying significant gaps in care and common challenges faced by meningioma patients, which underscores the necessity for improved support systems (ref: Nassiri doi.org/10.1093/noajnl/). Zamanipoor Najafabadi et al. focused on long-term disease burden, revealing that many patients experience ongoing health-related quality of life issues and neurocognitive impairments even five years post-treatment, highlighting the need for continuous monitoring and supportive care (ref: Zamanipoor Najafabadi doi.org/10.1093/neuros/). Furthermore, Maier et al. explored TERT promoter mutations in malignant meningiomas, suggesting that genetic factors may influence patient outcomes and experiences, thus integrating molecular insights into the patient care narrative (ref: Maier doi.org/10.1111/bpa.12892/). Collectively, these studies emphasize the importance of addressing both the medical and psychosocial aspects of meningioma treatment to enhance patient well-being and recovery.

Epidemiological studies have provided valuable insights into the risk factors associated with meningioma development. Ogawa et al. examined the relationship between body mass index (BMI) and height with brain tumor risk in a Japanese cohort, finding a positive association that suggests lifestyle factors may play a role in tumorigenesis (ref: Ogawa doi.org/10.1016/j.annepidem.2020.06.001/). Similarly, Ben-Zion Berliner et al. analyzed data from two million Israeli adolescents, identifying height and female sex as significant risk factors for meningioma in adulthood, reinforcing the need for further investigation into developmental influences on tumor risk (ref: Ben-Zion Berliner doi.org/10.1186/s12885-020-07292-4/). These findings highlight the potential for early identification of at-risk populations and the importance of considering demographic and biological factors in meningioma research. The integration of these epidemiological insights with clinical data could enhance understanding of meningioma etiology and inform preventive strategies.

Adjuvant therapies play a critical role in the management of meningiomas, particularly in atypical cases. Lee et al. compared outcomes between patients receiving adjuvant radiation therapy (RT) and those undergoing surveillance after surgical resection, revealing that patients who received RT had larger tumors and were more likely to experience local progression, suggesting that upfront RT may not always confer the expected benefits (ref: Lee doi.org/10.1016/j.ijrobp.2020.08.015/). Chen et al. further contributed to this discourse by presenting a prognostic gene-expression signature that effectively stratified patients based on recurrence risk, indicating that molecular profiling could guide adjuvant treatment decisions (ref: Chen doi.org/10.1093/neuros/). Additionally, the study by Woelke et al. on cerebrospinal fluid alterations in ataxia telangiectasia, while not directly related to meningioma, underscores the broader implications of understanding inflammatory processes in CNS tumors (ref: Woelke doi.org/10.1007/s12311-020-01175-x/). Collectively, these studies emphasize the need for a tailored approach to adjuvant therapies, considering both clinical and molecular factors to optimize treatment outcomes.