Meningiomas, the most common primary intracranial tumors, have seen advancements in classification and prognostic evaluation through integrated molecular and morphologic approaches. One study developed an integrated molecular-morphologic score that significantly improved the accuracy of meningioma stratification, achieving a c-index of 0.744, which outperformed traditional WHO grading methods (ref: Maas doi.org/10.1200/JCO.21.00784/). Another innovative approach utilized a 3D convolutional neural network to classify major intracranial tumor types, including meningiomas, based on postcontrast T1-weighted MRI scans. This algorithm demonstrated high sensitivity and predictive values, with AUCs ranging from 0.97 to 1.00 across various classes, indicating its potential for clinical application in tumor identification (ref: Chakrabarty doi.org/10.1148/ryai.2021200301/). Additionally, the introduction of a novel meningioma surface factor (SF) to quantify shape irregularity on imaging correlated significantly with WHO grades, suggesting that SF could serve as an independent prognostic factor (ref: Popadic doi.org/10.3171/2021.5.JNS204223/). These studies collectively highlight the importance of integrating advanced imaging and molecular data for enhanced prognostic accuracy in meningioma patients.

The treatment landscape for meningiomas, particularly recurrent WHO grade II and III tumors, is evolving with studies exploring the efficacy of systemic therapies and radiation strategies. A randomized phase II study evaluated trabectedin for recurrent meningiomas, revealing a median progression-free survival (PFS) of 4.17 months in the observational cohort compared to 2.43 months in the trabectedin arm, although the results did not reach statistical significance (ref: Preusser doi.org/10.1093/neuonc/). In contrast, a propensity score-adjusted analysis of adjuvant radiation versus observation post-gross-total resection of WHO grade II meningiomas indicated that observation with salvage radiation yielded impressive recurrence-free survival rates of 97.7%, 90.3%, and 87.9% at 3, 5, and 10 years, respectively (ref: Momin doi.org/10.3171/2021.4.JNS21559/). Furthermore, the role of metformin in reducing the incidence of benign brain tumors, including meningiomas, in patients with type 2 diabetes mellitus was highlighted, suggesting a potential protective effect that warrants further investigation (ref: Tseng doi.org/10.3390/biom11101405/). These findings underscore the need for personalized treatment strategies based on tumor characteristics and patient profiles.

Recent research has illuminated the genetic and molecular underpinnings of meningiomas, particularly in relation to hereditary factors and mitochondrial DNA variations. A study identified the co-occurrence of meningiomas in patients with malignant pleural mesothelioma harboring germline BAP1 mutations, emphasizing the role of this tumor suppressor gene in tumorigenesis (ref: Hu doi.org/10.1016/j.jtho.2021.08.765/). Additionally, mitochondrial DNA sequence variations were found to significantly correlate with meningioma risk, particularly among females and individuals of African descent, highlighting demographic disparities in tumor incidence (ref: Samanic doi.org/10.1007/s11060-021-03878-5/). The utility of T2 relaxation time as a quantitative predictor of meningioma consistency was also demonstrated, revealing significant correlations with intraoperative consistency measurements, which could enhance surgical planning (ref: Yamada doi.org/10.1016/j.wneu.2021.10.135/). These insights into the genetic landscape and imaging biomarkers of meningiomas pave the way for targeted therapies and improved surgical outcomes.

The role of radiation therapy and imaging techniques in managing meningiomas has been a focal point of recent studies, particularly concerning the risks associated with radiation exposure and advancements in imaging technology. A study investigating risk factors for radiation necrosis in patients undergoing cranial stereotactic radiosurgery found that larger tumor diameters and higher radiation doses significantly increased the likelihood of necrosis, underscoring the need for careful dose management (ref: Kerschbaumer doi.org/10.3390/cancers13194736/). Furthermore, the Interphone study evaluated the impact of low-dose radiation from diagnostic examinations on meningioma risk, revealing a complex relationship that necessitates further exploration (ref: Auvinen doi.org/10.1093/ije/). Innovations in imaging, such as the application of chaotic Harris Hawks optimization for enhancing convolutional neural network designs, have shown promise in classifying brain tumors, including meningiomas, with superior performance compared to traditional methods (ref: Basha doi.org/10.3390/s21196654/). These findings highlight the dual role of radiation in treatment and potential risk, as well as the importance of advanced imaging techniques in improving diagnostic accuracy.

The psychological impact and quality of life (QoL) of patients with meningiomas have garnered attention, revealing significant insights into the long-term effects of treatment and disease management. A study assessing long-term health-related quality of life in skull base meningioma patients indicated that those with posterior skull base meningiomas reported poorer QoL compared to anterior/middle skull base patients, with radiotherapy as a contributing factor to diminished outcomes (ref: Fisher doi.org/10.3171/2021.4.JNS203891/). Additionally, research on psychological distress in patients with asymptomatic meningiomas and those with favorable postoperative outcomes found that distress levels remained high, indicating a need for supportive care strategies (ref: Kalasauskas doi.org/10.1007/s00701-021-05004-w/). The aesthetic and functional outcomes of surgical interventions, such as hydroxyapatite cement cranioplasty, were also evaluated, demonstrating positive long-term satisfaction among patients, which is crucial for holistic care (ref: Martinez-Perez doi.org/10.1007/s00701-021-05024-6/). These studies collectively emphasize the importance of addressing psychological well-being and QoL in the management of meningioma patients.

Innovations in surgical techniques for meningioma resection have been pivotal in improving patient outcomes and minimizing complications. A novel septal rhinopharyngeal flap technique for skull base reconstruction after endoscopic endonasal clivectomies has shown promise in reducing cerebrospinal fluid (CSF) leak rates, enhancing surgical safety (ref: Simal-Julian doi.org/10.3171/2021.6.JNS203882/). The exploration of chromatin remodeler complexes, such as ATRX-DAXX-H3.3, in meningiomas has revealed insights into telomere length maintenance and its implications for tumor biology (ref: Cavalcante doi.org/10.1016/j.clineuro.2021.106962/). Furthermore, a case study on the complete removal of bilateral clinoidal meningiomas through a pterional approach highlighted the complexities involved in managing these challenging tumors, achieving a Simpson grade 1 resection (ref: Campero doi.org/10.1093/ons/). These advancements underscore the continuous evolution of surgical strategies aimed at optimizing outcomes for meningioma patients.

Understanding the epidemiology and risk factors associated with meningiomas is crucial for developing preventive strategies and improving patient outcomes. Recent studies have identified significant associations between meningioma risk and demographic factors such as female gender, African American race, and obesity, with odds ratios indicating a heightened risk among these groups (ref: Samanic doi.org/10.1007/s11060-021-03878-5/). The development of a population-based atlas to explore the distribution of intracranial meningiomas has provided valuable insights into predilection sites and associated risk factors, enhancing our understanding of tumor behavior (ref: Hosainey doi.org/10.1007/s10143-021-01652-9/). Additionally, the utility of T2 relaxation time as a predictor of meningioma consistency has implications for surgical planning, emphasizing the importance of imaging in assessing tumor characteristics (ref: Yamada doi.org/10.1016/j.wneu.2021.10.135/). These findings contribute to a comprehensive understanding of meningioma epidemiology and highlight the need for targeted research in at-risk populations.