The clinical management of meningiomas is guided by comprehensive guidelines such as those from the NCCN, which address various CNS cancers, including meningiomas. These guidelines emphasize the importance of surgical intervention, radiotherapy, and systemic therapies tailored to the tumor's characteristics and patient health. Recent studies highlight the prognostic significance of factors like the MCM6 proliferative index, which correlates with survival outcomes in atypical meningiomas, indicating that higher MCM6 levels are associated with shorter progression-free and overall survival rates (ref: Gauchotte doi.org/10.3390/cancers15020535/). Additionally, volumetric extent of resection has been shown to significantly impact survival rates in recurrent atypical meningiomas, with 1-, 2-, and 5-year actuarial progression-free survival rates reported at 76%, 56%, and 34%, respectively (ref: Przybylowski doi.org/10.3171/2022.12.JNS221815/). Long-term health-related quality of life (HRQOL) assessments reveal that patients with subfrontal meningiomas experience better postoperative outcomes, with reduced anxiety and depression compared to reference populations (ref: Kofoed Lauridsen doi.org/10.3171/2022.9.JNS22826/). Furthermore, the management of WHO Grade II meningiomas indicates a higher relapse rate in patients undergoing a 'watch and wait' approach compared to those receiving postoperative adjuvant treatment (ref: Migliorati doi.org/10.3390/life13010037/).

Molecular and genetic research into meningiomas has unveiled significant insights into their pathogenesis and potential therapeutic targets. A study on rhabdoid meningiomas identified a range of chromosomal alterations, with monosomy 22 being the most common, suggesting a critical role in tumor behavior (ref: Garrido Ruiz doi.org/10.3390/ijms24021116/). Additionally, differential plasma metabolites have been identified as potential biomarkers for distinguishing between high-grade and low-grade meningiomas, with an impressive area under the curve of 95.7% for the predictive model (ref: Kurokawa doi.org/10.3390/ijms24010394/). Immunohistochemical studies have also shown promise in classifying meningiomas into distinct biological subtypes, although replicability remains a challenge, with only 26.2% of samples successfully allocated to specific groups (ref: Näslund doi.org/10.1016/j.bas.2022.101711/). These findings underscore the need for further exploration of genetic markers and their implications for personalized treatment strategies.

Innovations in surgical techniques for meningiomas have significantly improved patient outcomes. The introduction of high correlative non-local networks for surgical scene segmentation enhances the precision of micro-neurosurgical procedures (ref: Luo doi.org/10.1016/j.compbiomed.2022.106531/). Clinical outcomes following microsurgical resection of giant lateral ventricular meningiomas indicate a higher median blood loss and functional deterioration compared to smaller tumors, highlighting the complexities involved in managing larger lesions (ref: Cao doi.org/10.1007/s10143-022-01932-y/). The anterolateral approach with limited mastoidectomy has been proposed as an effective method for accessing jugular foramen meningiomas, demonstrating the importance of tailored surgical strategies based on tumor location and characteristics (ref: Giammattei doi.org/10.1007/s00701-022-05482-6/). Furthermore, advancements in MRI-based detection methods using deep learning have shown high accuracy in diagnosing various brain tumors, including meningiomas, which could facilitate earlier intervention (ref: Saeedi doi.org/10.1186/s12911-023-02114-6/).

Recent advancements in radiological imaging techniques have enhanced the diagnostic and prognostic capabilities for meningiomas. A novel MRI-based radiomics model has been developed to predict mitosis cycles in intracranial meningiomas, demonstrating promising accuracy, particularly in cases with zero or multiple mitoses (ref: Krähling doi.org/10.1038/s41598-023-28089-y/). Additionally, the classification and microsurgical treatment of foramen magnum meningiomas have been refined through retrospective analyses, leading to improved surgical outcomes (ref: Wu doi.org/10.1186/s41016-022-00315-y/). The unique magnetic resonance spectroscopy profiles of meningiomas compared to gliomas have also been characterized, revealing significant differences in metabolite levels that could aid in differential diagnosis (ref: De Stefano doi.org/10.1007/s13760-022-02169-8/). These imaging advancements not only improve diagnostic accuracy but also inform treatment planning and monitoring.

Understanding prognostic factors and their impact on quality of life in meningioma patients is crucial for optimizing treatment strategies. Studies have shown that long-term postoperative HRQOL is significantly better in patients with subfrontal meningiomas, who experience lower levels of anxiety and depression compared to general populations (ref: Kofoed Lauridsen doi.org/10.3171/2022.9.JNS22826/). The efficacy of phase II clinical trials for meningiomas remains a topic of debate, as the lack of consensus on appropriate endpoints complicates the evaluation of treatment effectiveness (ref: Watanabe doi.org/10.1007/s43441-022-00494-x/). Furthermore, the endoscopic endonasal approach for anterior clinoidal meningiomas has been highlighted as a promising surgical technique, potentially improving patient outcomes by minimizing complications associated with traditional approaches (ref: Bao doi.org/10.1007/s00701-022-05480-8/). These insights emphasize the importance of integrating quality of life assessments into clinical practice and research.

Innovative treatment modalities for meningiomas are evolving, with a focus on minimizing side effects while maximizing therapeutic efficacy. Robotic fractionated radiotherapy has been shown to significantly impact the eye structure and function in patients with benign tumors of the parasellar region, although the reduction in endothelial cell density did not impair vision (ref: Orski doi.org/10.3390/jcm12020404/). The investigation of dose gradient indices in intensity-modulated radiation therapy (IMRT) for optic nerve sheath meningiomas revealed that finer dose calculation grid sizes significantly improved dosimetric parameters, suggesting a need for precision in treatment planning (ref: Esmailzadeh doi.org/10.1016/j.apradiso.2023.110657/). Additionally, the management of progestogen-induced meningiomas has been explored, with findings indicating that discontinuation of progestogens followed by either surgical or conservative management can yield favorable outcomes (ref: Ahmed-Khalifa doi.org/10.1111/fcp.12878/). These advancements reflect a growing emphasis on personalized and targeted treatment approaches in meningioma care.

Immunological and biomarker studies are shedding light on the complex biology of meningiomas and their potential therapeutic implications. Research on antibody profiling has revealed differential reactive antibody signatures between glioblastomas and meningiomas, highlighting the potential for immuno-oncological strategies to enhance treatment efficacy (ref: Milchram doi.org/10.3390/ijms24021411/). Additionally, the identification of plasma metabolites as biomarkers for high-grade and low-grade meningiomas demonstrates the potential for non-invasive diagnostic tools, with significant statistical validation achieved (ref: Kurokawa doi.org/10.3390/ijms24010394/). Furthermore, the impact of varying dose calculation grid sizes on treatment planning for optic nerve sheath meningiomas underscores the importance of precision in radiotherapy to optimize patient outcomes (ref: Esmailzadeh doi.org/10.1016/j.apradiso.2023.110657/). These studies collectively emphasize the need for continued exploration of immunological markers and their role in the management of meningiomas.