The clinical management of meningiomas, particularly chordoid meningiomas, has been a focus of recent research. A study identified 12 primary chordoid meningiomas from a cohort of 1897 resected meningiomas, highlighting the need for a unifying molecular genetic signature due to the varied recurrence rates observed (ref: Daoud doi.org/10.1186/s40478-022-01362-3/). Another investigation into WHO grade I skull base meningiomas revealed that factors such as Ki-67 proliferation index and Simpson resection grade significantly correlate with recurrence-free survival (RFS) following incomplete resection, based on a retrospective analysis of 115 patients over a mean follow-up of 78 months (ref: Park doi.org/10.3171/2022.3.JNS2299/). Additionally, the clinical and pathological implications of brain invasion in grade 2 meningiomas were examined, revealing that 26.4% of meningiomas were classified as grade 2 based solely on brain invasion, emphasizing the importance of collaborative assessments between neurosurgeons and neuropathologists (ref: Picart doi.org/10.1007/s10143-022-01792-6/). Furthermore, advancements in surgical techniques, such as the combined endoscopic endonasal and transorbital approach, have shown promise for complex skull base lesions, suggesting a shift towards more innovative surgical strategies (ref: Lee doi.org/10.1007/s00701-022-05203-z/).

Recent studies have provided significant insights into the molecular and genetic landscape of meningiomas. The loss of H3K27me3, a histone modification, has been identified as a potential predictor of shorter progression-free survival after stereotactic radiosurgery, indicating its relevance in clinical outcomes (ref: Ammendola doi.org/10.3390/cancers14071718/). Additionally, the effects of disulfiram and copper on meningioma cell viability were explored, revealing that this combination could induce apoptosis in malignant meningioma cells, thus presenting a potential therapeutic avenue (ref: Kao doi.org/10.3390/biomedicines10040887/). Furthermore, the expression of oncogenes targeted by decitabine was analyzed in vivo, showing high expression levels in meningiomas and correlating with clinical outcomes, which may inform future treatment strategies (ref: Canisius doi.org/10.1007/s10143-022-01789-1/). The evaluation of proliferative markers such as Ki67, p53, and p57 in meningiomas also revealed no significant differences between grades I and II, suggesting that these markers may not be as reliable for distinguishing tumor behavior as previously thought (ref: Küçükosmanoğlu doi.org/10.3340/jkns.2021.0197/).

The advancement of imaging techniques has significantly impacted the diagnosis and management of meningiomas. A study demonstrated that deep learning algorithms could enhance the segmentation of meningiomas from multiparametric MRI, achieving comparable accuracy to manual segmentation methods, which is crucial for preoperative differentiation (ref: Chen doi.org/10.1007/s00330-022-08749-9/). Moreover, a novel approach using coated blade spray-mass spectrometry (CBS-MS) was introduced for rapid characterization of brain tumors, potentially streamlining diagnostic processes (ref: Bogusiewicz doi.org/10.3390/molecules27072251/). Additionally, the application of cycle-consistent adversarial networks (CycleGAN) improved the generalizability of radiomics models in grading meningiomas, indicating a promising direction for enhancing diagnostic accuracy in external validation settings (ref: Park doi.org/10.1038/s41598-022-10956-9/). The exploration of noninvasive detection methods through numerical analysis of optical fluence rates at the scalp also presents a novel approach for distinguishing normal brain tissue from tumors, further expanding the diagnostic toolkit (ref: Mahdy doi.org/10.1364/JOSAA.446677/).

Innovative treatment strategies for meningiomas are being explored to enhance therapeutic efficacy. A study found that the combination of gemcitabine with the mTOR inhibitor everolimus significantly inhibited malignant meningioma cell growth and sensitized these cells to apoptosis induced by navitoclax, suggesting a multi-drug approach could be beneficial (ref: Yamamoto doi.org/10.3390/cancers14071706/). Additionally, the management of sphenoid wing meningiomas with cavernous sinus invasion was examined, emphasizing the importance of preserving quality of life and cranial nerve function during surgical interventions (ref: da Silva doi.org/10.1016/j.wneu.2022.04.050/). The presentation and management of spinal meningiomas were also reviewed, highlighting the rarity of these tumors and the need for tailored surgical approaches based on individual patient characteristics (ref: Wang doi.org/10.1080/02688697.2022.2061419/). Furthermore, the distinct slow-wave activity patterns observed in patients with low-grade gliomas and meningiomas indicate a potential link between tumor type and language functioning, which could inform preoperative assessments and postoperative rehabilitation strategies (ref: Wolthuis doi.org/10.3389/fnhum.2022.748128/).

The psychosocial impact of meningiomas on patients has gained attention, particularly concerning anxiety and depression. A mixed-methods analysis revealed that 28.6% of patients undergoing surgical management experienced mild to severe anxiety symptoms, while 50% of those under active surveillance reported similar symptoms, indicating a significant psychological burden associated with meningioma diagnosis (ref: Kasper doi.org/10.1186/s40359-022-00797-6/). The emerging relevance of H3K27 trimethylation loss as a prognostic factor in meningiomas was also highlighted, with a meta-analysis suggesting that this loss correlates with increased recurrence rates, thus impacting patient outcomes and quality of life (ref: Lu doi.org/10.1016/j.wneu.2022.04.048/). The surgical management of sphenoid wing meningiomas with cavernous sinus invasion further emphasizes the need to consider quality of life and cranial nerve function preservation, as visual impairment is a common concern affecting patients' overall well-being (ref: da Silva doi.org/10.1016/j.wneu.2022.04.050/).

Surgical techniques for meningioma resection have evolved, with innovative approaches being developed to enhance outcomes. A study comparing a two-stage combined anterolateral and endoscopic endonasal approach to traditional methods demonstrated improved anatomical access to the petroclival region, suggesting that this technique may address limitations of previous approaches (ref: Labib doi.org/10.1007/s00701-022-05201-1/). The combined endoscopic endonasal and transorbital approach has also shown promise for complex skull base lesions, indicating a shift towards multiportal strategies that may improve surgical efficacy and patient outcomes (ref: Lee doi.org/10.1007/s00701-022-05203-z/). However, challenges remain, as illustrated by cases of postoperative neurologic deterioration following laminectomy for ventral meningioma resection, prompting discussions on alternative approaches to mitigate such risks (ref: Harel doi.org/10.1055/a-1832-3393/). These advancements underscore the importance of continual innovation in surgical techniques to optimize patient care and minimize complications.

Understanding the factors influencing recurrence in meningiomas is critical for improving patient outcomes. A study on WHO grade I skull base meningiomas identified significant associations between Ki-67 proliferation index and Simpson resection grade with recurrence-free survival, highlighting the importance of these markers in predicting regrowth after incomplete resection (ref: Park doi.org/10.3171/2022.3.JNS2299/). The development of a deep learning-based automatic segmentation method for meningiomas has also shown potential in enhancing preoperative differentiation, which could aid in surgical planning and prognostication (ref: Chen doi.org/10.1007/s00330-022-08749-9/). Furthermore, the clinical and pathological assessment of brain invasion in meningiomas has been emphasized, with findings indicating that a significant proportion of tumors classified as grade 2 were based on this criterion alone, suggesting that brain invasion should be a critical consideration in diagnosis and treatment planning (ref: Picart doi.org/10.1007/s10143-022-01792-6/). The Ki67 index has been identified as a powerful predictor of recurrence in atypical meningiomas, with a retrospective analysis revealing a mean recurrence-free survival of 149.3 months, underscoring its utility in clinical practice (ref: Lee doi.org/10.3340/jkns.2021.0196/).