Recent studies have focused on various management strategies for meningiomas, particularly the efficacy of stereotactic radiosurgery (SRS) compared to conservative management. The IMPASSE study demonstrated that SRS achieved a remarkable tumor control rate of 99.0%, significantly higher than the 64.2% observed in conservatively managed patients (P < .001; OR 56.860 [95% CI 26.253-123.150]), with minimal new neurological deficits reported in both groups (2.5% for SRS vs. 2.8% for conservative management, P = .764) (ref: Sheehan doi.org/10.1093/neuonc/). Additionally, the role of Gamma Knife radiosurgery (GKRS) in treating neurofibromatosis type 2-associated meningiomas has been explored, highlighting the need for further clarity on its outcomes and complications (ref: Mohammed doi.org/10.3171/2020.12.JNS202814/). Furthermore, a systematic review indicated that carbon ion radiotherapy (CI-RT) is comparable in efficacy and safety to proton radiotherapy (PR-RT) and superior to photon radiotherapy (PH-RT) for meningiomas, suggesting a potential shift in treatment paradigms (ref: Li doi.org/10.3389/fonc.2021.620534/). The analysis of recurrence patterns in grade II meningiomas post-radiotherapy revealed critical insights into target volume definitions and areas of tumor re-growth, emphasizing the importance of precise treatment planning (ref: Hoffmann doi.org/10.1186/s13014-021-01825-2/).

The epidemiological landscape of meningiomas has been characterized by significant trends in incidence rates across various demographics. A comprehensive analysis of data from the Surveillance, Epidemiology, and End Results (SEER) registries indicated that the overall incidence of nonmalignant meningiomas increased significantly from 2004 to 2009 (APC, 5.4%; 95% CI, 4.4%-6.4%) but slowed thereafter (APC, 1.0%; 95% CI, 0.6%-1.5%) (ref: Withrow doi.org/10.1002/cncr.33553/). In a regional study from Miyazaki Prefecture, the age-adjusted incidence rate of meningiomas was found to be higher than in previous surveys, highlighting geographical variations in tumor prevalence (ref: Matsumoto doi.org/10.2176/nmc.oa.2020-0438/). Moreover, a multiethnic cohort study linked airport-related ultrafine particles to an increased risk of malignant brain cancers, including meningiomas, suggesting environmental factors may play a role in tumor development (ref: Wu doi.org/10.1158/0008-5472.CAN-21-1138/). These findings underscore the necessity for ongoing surveillance and research to understand the factors influencing meningioma incidence.

The impact of meningiomas on neuropsychological functioning and quality of life has garnered attention, particularly in relation to surgical outcomes. A study focusing on patients with olfactory groove meningiomas revealed significant pre- and postoperative neuropsychological deficits, emphasizing the need for thorough cognitive assessments in this patient population (ref: Constanthin doi.org/10.3390/cancers13112520/). Additionally, research indicated that hope and distress levels were not significantly associated with the stage of brain tumors, suggesting that psychological outcomes may not correlate directly with tumor grade (ref: Mayer doi.org/10.3389/fpsyg.2021.642345/). This finding highlights the importance of psychological support across all stages of meningioma treatment, as lower-grade patients experienced similar levels of distress as those with higher-grade tumors. Overall, these studies advocate for integrated psycho-oncological care to enhance patient quality of life.

Molecular and genetic research has advanced the understanding of meningiomas, particularly in identifying prognostic markers and therapeutic targets. A systematic review identified several biomarkers, including methylation patterns and CDKN2A/B alterations, which may aid in differentiating between grade I and grade II meningiomas, although clinically validated preoperative biomarkers remain elusive (ref: Sofela doi.org/10.1080/02688697.2021.1940853/). Furthermore, the substantial loss of H3K27me3 expression was found to be a significant prognostic factor for early recurrence in grade II meningiomas, although it did not predict outcomes in grade III tumors (ref: Jung doi.org/10.1016/j.humpath.2021.06.005/). Additionally, advancements in proteomics have opened new avenues for biomarker validation in brain tumors, suggesting a potential shift towards more personalized treatment approaches (ref: Ghantasala doi.org/10.3389/fonc.2021.548243/).

Innovations in radiotherapy and surgical techniques for meningiomas have shown promising results in improving patient outcomes. A systematic review highlighted the efficacy and safety of carbon ion radiotherapy (CI-RT), which was found to be as effective as proton radiotherapy (PR-RT) and superior to photon radiotherapy (PH-RT) in treating meningiomas (ref: Li doi.org/10.3389/fonc.2021.620534/). Additionally, a retrospective analysis of grade II meningiomas post-radiotherapy revealed critical insights into recurrence patterns and the importance of precise target volume definitions in treatment planning (ref: Hoffmann doi.org/10.1186/s13014-021-01825-2/). The use of N-butyl 2-cyanoacrylate (nBCA) for preoperative tumor embolization has also been explored, demonstrating its utility in complex cases where traditional methods may be challenging (ref: Dossani doi.org/10.1136/neurintsurg-2021-017400/). These advancements underscore the evolving landscape of meningioma treatment, emphasizing the need for continued research into novel therapeutic strategies.

The surgical management of meningiomas is associated with various complications and risk factors that can significantly impact patient outcomes. A study comparing unfractionated heparin (UFH) dosing regimens found that a thrice-daily (TID) dosing schedule was associated with a lower rate of pulmonary embolism compared to a twice-daily (BID) regimen (TID rate 0% vs. BID rate 10.6%, P = 0.044) (ref: Thirunavu doi.org/10.1016/j.wneu.2021.06.076/). Additionally, the effect of radiation on meningioma volume change was assessed, revealing that WHO grade I meningiomas experienced an average volume decrease of 33% ± 19%, while grade II tumors decreased by 30% ± 23% (ref: Hall doi.org/10.1016/j.wneu.2021.06.080/). The development of an antibody-drug conjugate targeting somatostatin receptor 2 (SSTR2) has also been investigated as a potential therapeutic approach for recurrent meningiomas, highlighting the need for effective targeted therapies (ref: Chen doi.org/10.3390/ph14050427/). These findings emphasize the importance of understanding surgical risks and complications to optimize management strategies.

Innovative treatment approaches for meningiomas are being explored to enhance therapeutic efficacy and patient outcomes. The use of N-butyl 2-cyanoacrylate (nBCA) for preoperative tumor embolization has shown promise in facilitating surgical procedures, particularly in challenging anatomical situations (ref: Dossani doi.org/10.1136/neurintsurg-2021-017400/). Additionally, the substantial loss of H3K27me3 expression has been identified as a prognostic factor for early recurrence in grade II meningiomas, suggesting that molecular markers could guide treatment decisions (ref: Jung doi.org/10.1016/j.humpath.2021.06.005/). Furthermore, the psychological dimensions of treatment have been highlighted, with studies indicating that hope and distress levels are critical factors influencing patient quality of life, regardless of tumor grade (ref: Mayer doi.org/10.3389/fpsyg.2021.642345/). These innovative approaches underscore the need for a multidisciplinary strategy in managing meningiomas, integrating molecular insights with psychological support.

The pathological and imaging characteristics of meningiomas are crucial for understanding tumor behavior and guiding treatment. A study assessing the long-term outcomes of Simpson IV meningioma resections indicated that adjuvant stereotactic radiosurgery (SRS) may improve patient outcomes, although further research is needed to confirm these findings (ref: Dedeciusova doi.org/10.1016/j.clineuro.2021.106766/). Additionally, the use of piezosurgery for safe and efficient petrous bone cutting in cerebellopontine angle and petroclival meningioma surgeries has been evaluated, demonstrating its efficacy in enhancing surgical precision (ref: Steiert doi.org/10.1016/j.jocn.2021.05.021/). Moreover, a modified frailty index was found to be a significant predictor of postoperative morbidity and mortality in patients undergoing surgery for large and giant petroclival meningiomas, highlighting the importance of preoperative assessments (ref: Roux doi.org/10.1007/s10143-021-01580-8/). These insights into pathological and imaging characteristics are vital for optimizing surgical strategies and improving patient outcomes.