Recent studies have significantly advanced our understanding of the molecular and genetic landscape of meningiomas, the most common primary intracranial tumors. Prager et al. explored the enhancer landscape of 33 meningioma tumors, identifying three distinct biological subgroups characterized by their hormonal lineage transcriptional regulators: adipogenesis/cholesterol, mesodermal, and neural crest. This stratification not only provides insights into tumor biology but also highlights potential druggable dependencies, paving the way for targeted therapies (ref: Prager doi.org/10.1158/2159-8290.CD-20-0160/). Sievers et al. further contributed to this theme by demonstrating that homozygous deletions of CDKN2A/B are associated with early recurrence in meningiomas, emphasizing the importance of genetic alterations in predicting clinical outcomes (ref: Sievers doi.org/10.1007/s00401-020-02188-w/). Additionally, Findakly et al. investigated the role of primary cilia in meningioma cells, revealing that while these tumors express primary cilia, they do not transduce Hedgehog signals, which are crucial for cellular signaling and development (ref: Findakly doi.org/10.1186/s40478-020-00994-7/). This suggests a unique aspect of meningioma biology that may influence therapeutic strategies. Zheng et al. identified a polymorphism in the MALAT1 gene that modulates meningioma invasiveness through its interaction with collagen type V alpha, further illustrating the complex genetic interplay in tumor behavior (ref: Zheng doi.org/10.1111/jcmm.15637/).

The clinical outcomes and prognostic factors associated with meningiomas have been the focus of several recent studies, revealing critical insights into patient management. Mirian et al. examined the Ki-67 proliferation index as a marker for recurrence in meningioma patients, finding a significant correlation between higher Ki-67 levels and increased risk of tumor recurrence, adjusted for various clinical factors (ref: Mirian doi.org/10.1093/neuros/). Spille et al. compared postoperative tumor volume with the Simpson classification, identifying that any residual tumor volume significantly predicts recurrence, thus challenging traditional metrics of surgical success (ref: Spille doi.org/10.3171/2020.4.JNS20412/). In pediatric populations, Toland et al. highlighted the unique clinical and molecular characteristics of meningiomas in children, emphasizing the need for tailored diagnostic and treatment approaches distinct from adult cases (ref: Toland doi.org/10.1111/bpa.12884/). Furthermore, the impact of insurance on hospital readmission rates post-surgery was analyzed by Hauser et al., revealing that patients with Medicare and Medicaid had higher readmission rates compared to those with private insurance, indicating socioeconomic factors play a role in clinical outcomes (ref: Hauser doi.org/10.1007/s11060-020-03581-x/).

Innovations in surgical techniques for meningioma treatment have been pivotal in improving patient outcomes. Seo et al. conducted a comprehensive analysis of olfactory function changes post-endoscopic skull base surgery, revealing that extended approaches significantly worsen olfactory impairment compared to more conservative techniques (ref: Seo doi.org/10.4193/Rhin20.020/). Fisher et al. performed a systematic review and meta-analysis on spheno-orbital meningiomas, concluding that surgical outcomes vary widely based on the techniques employed, underscoring the need for standardized approaches (ref: Fisher doi.org/10.1111/aos.14517/). The use of augmented reality in surgical planning for clinoid meningiomas was explored by Jean et al., demonstrating enhanced precision in minimally invasive approaches (ref: Jean doi.org/10.1093/ons/). Additionally, Lepski et al. investigated electrophysiological predictors of hearing deterioration during petroclival meningioma resection, establishing a correlation between auditory evoked potential changes and surgical outcomes (ref: Lepski doi.org/10.1007/s10143-020-01350-y/). These studies collectively highlight the importance of refining surgical techniques to optimize patient safety and recovery.

Advancements in radiological imaging techniques have significantly enhanced the diagnosis and management of meningiomas. Parikh et al. demonstrated the utility of arterial spin labeling (ASL) MRI in differentiating sellar region meningiomas from pituitary adenomas, finding that meningiomas exhibited significantly higher blood flow compared to adenomas, which could aid in preoperative planning (ref: Parikh doi.org/10.1016/j.wneu.2020.07.039/). Wadiura et al. assessed the diagnostic accuracy of 5-ALA fluorescence during meningioma surgery, reporting a positive predictive value of 100% for tumor bulk, which underscores the potential of this technique in achieving complete resection (ref: Wadiura doi.org/10.1002/lsm.23294/). Furthermore, Park et al. compared radiosurgery and microsurgery for small petroclival meningiomas, finding equivalent tumor control rates, thus providing evidence for the effectiveness of both approaches in managing these tumors (ref: Park doi.org/10.1007/s10143-020-01346-8/). These imaging advancements not only improve diagnostic accuracy but also facilitate better surgical outcomes.

The focus on patient-centered care and quality of life in meningioma patients has gained traction, with studies identifying unmet needs and potential improvements in care pathways. Baba et al. conducted qualitative assessments to determine the unmet needs of meningioma patients and caregivers, emphasizing the necessity for tailored resources to support postoperative recovery and enhance health-related quality of life (ref: Baba doi.org/10.1093/nop/). Zamanipoor Najafabadi et al. further explored the structure of current meningioma care, identifying gaps that could be addressed through innovative initiatives, thereby optimizing care trajectories for patients (ref: Zamanipoor Najafabadi doi.org/10.1093/nop/). Zhang et al. developed a nomogram model to predict late postoperative seizures, providing a tool for clinicians to optimize surveillance and improve patient outcomes (ref: Zhang doi.org/10.1016/j.jocn.2020.06.005/). These studies highlight the importance of integrating patient perspectives into clinical practice to enhance overall care quality.

Understanding the tumor biology and pathology of meningiomas is crucial for developing effective treatment strategies. Findakly et al. highlighted that while meningioma cells express primary cilia, they do not transduce Hedgehog signals, indicating a unique aspect of their biology that may influence therapeutic approaches (ref: Findakly doi.org/10.1186/s40478-020-00994-7/). Giraldi et al. investigated the impact of male hormone-interfering drugs on meningioma development, finding no significant association, which suggests that hormonal factors may not play a critical role in the etiology of these tumors (ref: Giraldi doi.org/10.1093/noajnl/). Additionally, Marenco-Hillembrand et al. conducted a systematic review on minimally invasive surgical outcomes for deep-seated brain lesions, emphasizing the need for careful consideration of surgical techniques to minimize damage to surrounding tissue (ref: Marenco-Hillembrand doi.org/10.1016/j.wneu.2020.07.115/). These findings collectively contribute to a deeper understanding of meningioma pathology and inform future research directions.

The epidemiology and risk factors associated with meningiomas have been extensively studied, revealing important insights into their development. Apra et al. focused on spheno-orbital meningiomas, noting a significant prevalence among women and suggesting a potential link to progesterone exposure, which may influence tumor growth patterns (ref: Apra doi.org/10.1007/s11060-020-03576-8/). Giraldi et al. also examined the role of male hormone-interfering drugs, concluding that there is no significant association with meningioma occurrence, which adds complexity to the understanding of hormonal influences on tumor development (ref: Giraldi doi.org/10.1093/noajnl/). Hauser et al. analyzed the impact of insurance status on hospital readmission rates post-meningioma resection, revealing that patients with Medicare and Medicaid had higher readmission rates compared to those with private insurance, highlighting socioeconomic disparities in healthcare access and outcomes (ref: Hauser doi.org/10.1007/s11060-020-03581-x/). These studies underscore the multifaceted nature of meningioma risk factors and the need for continued research in this area.