Recent studies have significantly advanced our understanding of the molecular and genetic landscape of meningiomas, particularly focusing on specific subtypes and their unique characteristics. For instance, a study identified clear cell meningiomas as a distinct molecular subset characterized by a unique DNA methylation profile and frequent mutations in the SMARCE1 gene, highlighting the importance of genetic screening in this rare variant (ref: Sievers doi.org/10.1007/s00401-020-02247-2/). Another investigation into the Tübingen meningioma cohort revealed that loss of H3K27me3 trimethylation is associated with a higher risk of tumor recurrence, suggesting that this epigenetic marker could serve as a valuable prognostic tool in clinical settings (ref: Behling doi.org/10.1093/neuonc/). Furthermore, research on neurofibromatosis type 2 (NF2) patients indicated that those asymptomatic at diagnosis had better survival outcomes compared to symptomatic individuals, emphasizing the need for early detection and monitoring strategies (ref: Forde doi.org/10.1093/neuonc/). Additionally, the efficacy of decitabine in malignant meningioma cells was explored, revealing its potential to demethylate tumor suppressor genes and affect cell viability, independent of TERT expression (ref: Stögbauer doi.org/10.3171/2020.7.JNS193097/). Whole-exome sequencing studies have also uncovered overlapping genetic variants in blood, tissues, and cell lines from meningioma patients, predominantly in stem cell-related genes, which may provide insights into tumorigenesis and progression (ref: Hussein doi.org/10.1016/j.heliyon.2020.e05632/).

Clinical outcomes following meningioma surgery have been the focus of several recent studies, providing valuable insights into survival rates and recurrence patterns. A nationwide study utilizing the French Système National des Données de Santé database analyzed meningioma surgeries from 2007 to 2017, revealing critical survival data that can inform treatment protocols (ref: Champeaux-Depond doi.org/10.1016/j.canep.2020.101875/). Additionally, a systematic review and meta-analysis assessed the incidence of malignant transformation in WHO grade I meningiomas, finding an incidence rate of 2.98 per 1000 patient-years, indicating that while malignant transformation is rare, it is a significant concern that warrants further investigation (ref: Nakasu doi.org/10.1093/noajnl/). The development of spatial mechanistic modeling for predicting the growth of asymptomatic meningiomas also shows promise, as it could enhance patient management by allowing for tailored follow-up strategies based on predicted tumor behavior (ref: Collin doi.org/10.1016/j.cmpb.2020.105829/). Furthermore, a study from Nepal provided insights into clinical outcomes and recurrence rates post-surgery, emphasizing the need for localized data to improve treatment approaches in developing countries (ref: Raman doi.org/10.1016/j.wneu.2020.12.079/). Preoperative serum vitamin D levels were also investigated as a potential protective factor against peritumoral brain edema, suggesting that nutritional status may influence surgical outcomes (ref: Hajimohammadebrahim-Ketabforoush doi.org/10.1080/01635581.2020.1861311/).

The psychological impact and quality of life considerations for meningioma patients have gained attention in recent research, particularly regarding cognitive functioning and seizure control. A study examining the relationship between the APOE ε4 allele and cognitive performance in brain tumor patients found no significant differences in pretreatment cognitive abilities between carriers and non-carriers, suggesting that genetic factors may not play a role in initial cognitive impairment (ref: Butterbrod doi.org/10.1111/ene.14693/). Additionally, a systematic review of meningioangiomatosis cases indicated that surgical resection performed shortly after seizure onset significantly improves seizure control, highlighting the importance of timely intervention in managing this rare condition (ref: Roux doi.org/10.1212/WNL.0000000000011372/). Furthermore, the ESTRO ACROP guidelines for target volume delineation in skull base tumors emphasize the need for precise imaging and treatment planning to minimize adverse effects on quality of life (ref: Combs doi.org/10.1016/j.radonc.2020.11.014/). Long-term outcomes of Gamma Knife radiosurgery for large or documented growth asymptomatic meningiomas showed promising progression-free survival rates, suggesting that this treatment modality can effectively manage tumor growth while preserving quality of life (ref: Fu doi.org/10.3389/fonc.2020.598582/).

Innovations in surgical techniques for meningioma resection have been pivotal in improving patient outcomes, particularly for challenging cases such as large sphenoid wing meningiomas. A case series study reported on 21 patients with large sphenoid wing meningiomas, revealing that surgical strategies significantly impacted the quality of resection and postoperative recovery, with an average tumor size of 6.3 cm (ref: Balasa doi.org/10.3390/brainsci10120957/). Additionally, advancements in imaging technology, such as a 3D-MRI texture feature model, have shown promise in differentiating between solitary fibrous tumors and angiomatous meningiomas, potentially aiding in preoperative planning (ref: Dong doi.org/10.1155/2020/). A study assessing the outcomes of older patients undergoing supratentorial tumor resection highlighted the increased medical comorbidities in this demographic, underscoring the need for tailored surgical approaches (ref: Garcia doi.org/10.1016/j.jocn.2020.11.022/). Furthermore, the use of sterile gelatin film during re-resection has been associated with reduced cortical injury, suggesting that simple intraoperative innovations can lead to improved surgical outcomes (ref: Przybylowski doi.org/10.1093/ons/). Lastly, a meta-analysis exploring the relationship between oral contraceptive use and glioma/meningioma risk found no significant increase in risk among users, contributing to the ongoing discussion regarding hormonal influences on tumor development (ref: Yang doi.org/10.1016/j.wneu.2020.11.175/).

Radiation therapy remains a critical component in the management of meningiomas, particularly for patients with asymptomatic tumors or those not amenable to surgical resection. A long-term study on the outcomes of initial Gamma Knife radiosurgery (GKRS) for large or documented growth asymptomatic meningiomas reported impressive progression-free survival rates of 100%, 97%, and 97% at 3, 5, and 10 years, respectively, indicating the effectiveness of this treatment modality (ref: Fu doi.org/10.3389/fonc.2020.598582/). Additionally, a review of moderately hypofractionated radiation therapy for benign meningiomas and schwannomas demonstrated favorable outcomes, with patients receiving 30 Gy in 10 fractions showing promising results (ref: Dhere doi.org/10.1016/j.adro.2020.09.009/). The introduction of mask-based immobilization in GKRS has also improved treatment precision, allowing for better patient management and reduced motion artifacts during therapy (ref: Bush doi.org/10.1016/j.jocn.2020.11.033/). Furthermore, the relationship between oral contraceptive use and the risk of gliomas and meningiomas has been explored, with findings suggesting that OC use may not significantly increase the risk of these tumors, contributing to the understanding of hormonal influences in tumorigenesis (ref: Yang doi.org/10.1016/j.wneu.2020.11.175/).

Epidemiological studies have shed light on the risk factors associated with meningiomas, particularly in premenopausal women and the influence of hormonal conditions. A study focusing on premenopausal women with meningiomas highlighted the complex interplay between hormonal factors, including pregnancy and oral contraceptive use, and tumor development, although definitive conclusions remain elusive (ref: Maiuri doi.org/10.3389/fonc.2020.556701/). Additionally, a meta-analysis on the relationship between oral contraceptives and glioma/meningioma risk found that female users of OCs might have a reduced risk of glioma, suggesting a potential protective effect (ref: Yang doi.org/10.1016/j.wneu.2020.11.175/). Furthermore, a study examining brain herniation associated with intracranial meningiomas in dogs and cats provided insights into the clinical presentation and types of herniation, which may inform veterinary practices and contribute to comparative studies in human medicine (ref: Minato doi.org/10.1292/jvms.20-0111/). These findings underscore the need for ongoing research to clarify the epidemiological factors influencing meningioma development and progression.

Advancements in histopathological and diagnostic techniques have significantly improved the assessment and management of meningiomas. A study comparing glass slide imaging with whole slide imaging (WSI) for grading atypical meningiomas found that WSI provided higher intra-observer concordance and similar predictive accuracy for recurrence, suggesting its potential as a reliable diagnostic tool (ref: Ammendola doi.org/10.1007/s00428-020-02988-1/). Additionally, a comparative analysis of MRI characteristics according to the 2016 WHO pathological classification revealed distinct imaging features among different grades of meningiomas, with significant differences in ADC values, which could aid in preoperative planning and risk stratification (ref: Yu doi.org/10.1177/1533033820983287/). The investigation of fibroblast phenotypes in lateral ventricular meningiomas also provided insights into tumor growth mechanisms, emphasizing the importance of understanding the tumor microenvironment (ref: Sato doi.org/10.1016/j.wneu.2020.12.025/). Furthermore, the use of 3D-MRI texture feature models for differentiating between solitary fibrous tumors and angiomatous meningiomas represents a promising diagnostic innovation that could enhance preoperative decision-making (ref: Dong doi.org/10.1155/2020/). These diagnostic advancements are crucial for improving patient outcomes and tailoring treatment strategies.