Recent studies have highlighted significant disparities in the surgical management of meningiomas, particularly among racial groups. A registry-based cohort analysis revealed that Black patients had higher odds of being recommended against surgical resection for meningiomas compared to White patients, with an adjusted odds ratio of 1.73 (ref: Butterfield doi.org/10.1016/S0140-6736(22)00839-X/). This finding underscores the need for addressing racial and socioeconomic factors in treatment recommendations. In terms of therapeutic advancements, peptide receptor radionuclide therapy (PRRT) has emerged as a potential option for patients with progressive, treatment-refractory meningiomas, demonstrating efficacy in controlling tumor growth in a cohort of 15 patients (ref: Minczeles doi.org/10.1007/s00259-022-06044-9/). Furthermore, a study comparing surgical approaches for anterior skull base meningiomas found that the endoscopic expanded endonasal approach (EEEA) resulted in shorter hospital stays compared to the traditional open transcranial approach, suggesting a shift towards less invasive techniques (ref: Parasher doi.org/10.1177/19458924221145893/). Additionally, advancements in imaging techniques, such as deep learning-based tumor segmentation, have improved the precision of gamma knife radiosurgery planning for various intracranial tumors, including meningiomas (ref: Lee doi.org/10.1016/j.cmpb.2022.107311/).

The prognosis of meningiomas is influenced by various factors, including genetic mutations and clinical characteristics. A study investigating the association between tumor mutations and recurrence in Grade I/II meningiomas found that specific mutations could provide insights into oncologic outcomes, highlighting the need for genetic profiling in prognostic assessments (ref: Dullea doi.org/10.18632/oncoscience.570/). Another study aimed at validating the MAC-score for predicting increased MIB-1 indices in spinal meningiomas reported poor discriminative ability, indicating that existing models may require refinement for better predictive accuracy (ref: El-Hajj doi.org/10.3389/fonc.2022.1037495/). Additionally, a meta-analysis revealed that eczema may serve as a protective factor against brain cancer, including meningiomas, with a notable odds ratio of 0.74 (ref: Zhu doi.org/10.1186/s12885-022-10471-0/). This suggests that immune-related factors could play a role in meningioma risk, warranting further investigation into the underlying mechanisms. Furthermore, a pooled analysis of childhood cancer survivors indicated that cranial radiation exposure significantly increases the risk of developing meningiomas, emphasizing the importance of long-term monitoring in this population (ref: Timmermann doi.org/10.1007/s00066-022-02029-7/).

Molecular profiling has revolutionized the understanding of meningiomas, with DNA methylation studies revealing distinct molecular subgroups that correlate with clinical outcomes. A recent study identified four subgroups—Malignant, Intermediate, Benign A, and Benign B—through unsupervised hierarchical clustering, demonstrating significant heterogeneity within the same histological grade (ref: Singh doi.org/10.1007/s11060-022-04220-3/). Additionally, the expression of enhancer of zeste homolog 2 (EZH2) has been linked to poorer prognoses and immune infiltrate profiles in meningiomas, suggesting its potential as a therapeutic target (ref: Zeng doi.org/10.3389/fnins.2022.1076530/). Furthermore, the relationship between tumor mutations and recurrence was explored, revealing that specific genetic alterations could inform clinical management strategies (ref: Dullea doi.org/10.18632/oncoscience.570/). In the context of orbital meningiomas, the expression of progesterone receptors has been associated with tumor grading, providing additional prognostic insights (ref: Janah doi.org/10.31557/APJCP.2022.23.12.4137/). These findings collectively underscore the importance of integrating molecular and genetic data into clinical practice for improved patient outcomes.

Radiation therapy remains a cornerstone in the management of meningiomas, particularly for atypical variants. A study investigating the dose-response relationship in patients with newly diagnosed atypical meningiomas treated with adjuvant radiotherapy found a median dose of 61.2 Gy, correlating with improved local control and survival outcomes (ref: Kim doi.org/10.1007/s11060-022-04206-1/). Additionally, volumetric growth analysis of radiation-induced meningiomas (RIMs) provided insights into their growth patterns, indicating that careful monitoring is essential for managing these tumors post-radiation (ref: Entenmann doi.org/10.1007/s11060-022-04209-y/). Furthermore, advancements in imaging techniques, particularly the development of risk-scoring models based on clinical and radiological features, have shown promise in differentiating between low-grade and high-grade meningiomas, with performance metrics comparable to full MRI assessments (ref: Yao doi.org/10.3389/fonc.2022.1053089/). The integration of imaging data with clinical outcomes is crucial for optimizing treatment strategies and improving patient prognostication.

Quality of life (QoL) outcomes for meningioma patients have gained increasing attention, particularly in the context of treatment approaches. A cross-sectional cohort study assessed health-related quality of life in patients with incidental and operated meningiomas, revealing that those under active monitoring reported similar QoL outcomes to those who underwent surgical intervention (ref: Keshwara doi.org/10.1007/s11060-022-04198-y/). This finding suggests that active surveillance may be a viable option for select patients, potentially reducing the burden of unnecessary surgery. Additionally, a study evaluating the long-term effects of fractionated stereotactic radiotherapy on visual acuity and complications in patients with intraorbital tumors demonstrated significant improvements in visual field defects post-treatment, although small changes in exophthalmometry were also noted (ref: Gishti doi.org/10.1038/s41433-022-02356-0/). These insights emphasize the importance of considering patient-reported outcomes and QoL metrics in the management of meningiomas, as they can significantly influence treatment decisions and overall patient satisfaction.

Surgical techniques for meningioma resection have evolved, with a focus on minimizing invasiveness and optimizing outcomes. A comparative study of surgical approaches for anterior skull base meningiomas revealed that the endoscopic expanded endonasal approach (EEEA) resulted in shorter hospital stays compared to the traditional open transcranial approach, with average lengths of stay of 5.6 days versus 9.3 days, respectively (ref: Parasher doi.org/10.1177/19458924221145893/). This suggests a trend towards less invasive methods that may enhance recovery times. Furthermore, the long-term outcomes of chordoid meningiomas were found to be favorable compared to other WHO grade 2 subtypes, indicating that subtype-specific characteristics should guide surgical decision-making (ref: Ren doi.org/10.1227/neu.0000000000002272/). Additionally, advancements in automated brain tumor diagnosis using machine learning techniques have shown promise in accurately identifying meningiomas from MRI scans, potentially streamlining the diagnostic process (ref: Ali doi.org/10.3390/life12122036/). Collectively, these findings highlight the importance of refining surgical techniques and integrating technological advancements to improve patient outcomes in meningioma management.