Recent advances in the molecular biology of meningiomas have significantly enhanced our understanding of tumor behavior and treatment responses. A study analyzing 2,824 meningiomas, including molecular data from 1,686 tumors, identified key molecular biomarkers that correlate with treatment response, highlighting the heterogeneity in patient outcomes (ref: Wang doi.org/10.1038/s41591-024-03167-4/). Another investigation focused on RNA splicing alterations across different DNA-methylation groups, revealing that specific splicing events can predict tumor recurrence and patient prognosis, particularly in hypermitotic meningiomas (ref: Leclair doi.org/10.1093/neuonc/). Furthermore, a targeted gene expression biomarker was developed that demonstrated improved discrimination of outcomes and radiotherapy responses, achieving a 5-year area under the curve (AUC) of 0.81 for local recurrence (ref: Teranishi doi.org/10.1007/s00401-024-02791-1/). These findings underscore the potential of integrating molecular profiling into clinical decision-making for meningioma management. In addition to these biomarkers, the role of RNA-binding proteins (RBPs) has been elucidated, particularly IGF2BP1, which was found to regulate mRNA stability of FOXM1 target genes in hypermitotic meningiomas (ref: Leclair doi.org/10.1007/s00401-024-02788-w/). The study of chromosomal alterations, specifically the loss of chromosome 1p, has also been highlighted as a clinically relevant marker for increased recurrence risk, with a cut-off of 5% loss being particularly significant (ref: Maas doi.org/10.1007/s00401-024-02777-z/). Finally, the prognostic impact of progesterone receptor expression in meningiomas was examined, revealing differences in performance status and quality of life outcomes between PGR+ and PGR- groups (ref: Armocida doi.org/10.1016/j.wneu.2024.08.084/). Collectively, these studies illustrate the intricate molecular landscape of meningiomas and its implications for personalized treatment strategies.

The treatment landscape for meningiomas is evolving, with a focus on personalized approaches based on molecular and clinical characteristics. A study on NF2-related schwannomatosis demonstrated that a targeted gene expression biomarker could significantly improve predictions of meningioma outcomes and radiotherapy responses, achieving a 5-year AUC of 0.81 for local recurrence (ref: Teranishi doi.org/10.1007/s00401-024-02791-1/). Additionally, the exploration of MERTK as a therapeutic target revealed that inhibiting MERTK and AXL could reduce proliferation and enhance survival in meningioma cells, suggesting a novel intervention strategy (ref: Dave doi.org/10.1038/s41388-024-03131-z/). Surgical outcomes also remain a critical focus, particularly for complex cases such as sinodural meningiomas, where a retrospective analysis of 64 patients highlighted unique challenges and outcomes associated with their surgical management (ref: Birua doi.org/10.1016/j.jocn.2024.110804/). Furthermore, a meta-analysis comparing dural resection versus coagulation in spinal meningiomas raised questions about the traditional Simpson grading scale's effectiveness, indicating that coagulation may not significantly increase recurrence risk as previously thought (ref: de Oliveira doi.org/10.1007/s00701-024-06235-3/). These findings emphasize the need for ongoing evaluation of treatment strategies, integrating both surgical and molecular insights to optimize patient outcomes.

Genetic and epigenetic factors play a crucial role in the pathogenesis and prognosis of meningiomas. Recent studies have identified significant alterations in RNA splicing and chromosomal losses that correlate with tumor behavior. For instance, the upregulation of specific RNA-binding proteins, such as IGF2BP1, has been linked to increased mRNA stability in hypermitotic meningiomas, suggesting a potential mechanism by which these tumors maintain aggressive growth (ref: Leclair doi.org/10.1007/s00401-024-02788-w/). Additionally, the loss of chromosome 1p has been established as a clinically relevant marker, with a threshold of 5% loss indicating a heightened risk of recurrence across various WHO grades (ref: Maas doi.org/10.1007/s00401-024-02777-z/). The prognostic implications of these genetic factors are further underscored by studies examining the impact of progesterone receptor expression on patient outcomes. A retrospective analysis revealed that PGR+ meningiomas were associated with different clinical and surgical predictors compared to PGR- tumors, highlighting the importance of hormonal influences in tumor behavior (ref: Armocida doi.org/10.1016/j.wneu.2024.08.084/). Moreover, a meta-analysis exploring the prognostic utility of frailty in primary brain tumor surgeries indicated that frailty may serve as a valuable predictor of surgical outcomes, although further validation is needed (ref: Alare doi.org/10.1016/j.wneu.2024.08.003/). Together, these studies illustrate the intricate interplay between genetic alterations and clinical outcomes in meningiomas, paving the way for more tailored therapeutic approaches.

The epidemiology of meningiomas reveals significant insights into their growth patterns and clinical features. A study assessing the velocity and pattern of growth in meningiomas found that tumor growth kinetics correlate with radiological risk stratification and WHO grading, emphasizing the importance of monitoring tumor dynamics over time (ref: Häni doi.org/10.3171/2024.4.JNS2446/). This research highlights that understanding growth patterns can aid in predicting clinical outcomes and tailoring treatment strategies. Furthermore, the spatial distribution of meningiomas has been mapped using voxel-based lesion techniques, revealing that benign tumors are predominantly located in the midline anterior skull base, while malignant variants are more frequently found in the falcine/parasagittal region (ref: Patel doi.org/10.1227/neu.0000000000003149/). In addition to growth patterns, the clinical features of meningiomas, including their surgical outcomes, have been extensively studied. A review of surgical approaches for Rathke's cleft cysts and sellar meningiomas highlighted the need for individualized treatment plans based on tumor characteristics and surgeon expertise (ref: Shahzad doi.org/10.1007/s10143-024-02684-7/). Moreover, a systematic review of olfactory groove meningiomas underscored the necessity for objective assessments of olfactory function and quality of life outcomes, advocating for more comprehensive treatment pathways (ref: Khan doi.org/10.1007/s10143-024-02708-2/). Collectively, these findings emphasize the diverse clinical presentations of meningiomas and the importance of tailored management strategies based on individual tumor characteristics.

Surgical techniques for meningiomas continue to evolve, with recent studies exploring innovative approaches and their impact on patient outcomes. A systematic review comparing dural resection versus coagulation in spinal meningiomas raised critical questions about the effectiveness of traditional surgical grading systems, suggesting that coagulation may not significantly reduce recurrence rates as previously believed (ref: de Oliveira doi.org/10.1007/s00701-024-06235-3/). This finding prompts a reevaluation of surgical strategies, particularly in spinal cases where the balance between invasiveness and efficacy is crucial. Additionally, the introduction of hemilaminectomy in managing spinal schwannomas and meningiomas has shown promising functional outcomes, indicating that less invasive techniques may improve recovery times and reduce complications (ref: Muncan doi.org/10.1016/j.heliyon.2024.e35346/). The surgical management of sinodural meningiomas also presents unique challenges due to their complex anatomy, with a recent retrospective study highlighting the need for specialized techniques to optimize outcomes in these cases (ref: Birua doi.org/10.1016/j.jocn.2024.110804/). These studies collectively underscore the importance of adapting surgical techniques to the specific characteristics of meningiomas, ensuring that patient safety and treatment efficacy remain paramount.

Imaging and diagnostic techniques are critical in the management of meningiomas, with recent advancements enhancing tumor detection and characterization. Raman spectroscopy, combined with autofluorescence, has emerged as a promising method for in situ identification of neoplastic tissue during brain tumor surgeries, providing valuable information for delineating tumor boundaries (ref: Uckermann doi.org/10.1007/s11060-024-04809-w/). This technique could significantly improve surgical outcomes by aiding in the precise removal of tumor tissue while preserving surrounding healthy structures. Furthermore, angiographic features of meningiomas have been shown to predict the extent of preoperative embolization, with specific tumor locations and arterial feeders correlating with varying degrees of devascularization (ref: Matsoukas doi.org/10.1227/neu.0000000000003054/). This information is crucial for planning surgical interventions and optimizing patient outcomes. Additionally, the biological effective dose (BED) has been proposed as a predictor of local tumor control in stereotactic radiosurgery for parasellar meningiomas, suggesting that incorporating BED into treatment planning could enhance therapeutic efficacy (ref: Shaaban doi.org/10.1007/s11060-024-04804-1/). Collectively, these advancements in imaging and diagnostic techniques highlight their essential role in improving the management and outcomes of patients with meningiomas.

Histopathological and prognostic factors are pivotal in determining the clinical outcomes of meningiomas. Recent studies have focused on the prognostic impact of various biological markers, including progesterone receptor (PGR) expression, which has been linked to differences in performance status and quality of life among patients (ref: Armocida doi.org/10.1016/j.wneu.2024.08.084/). This research emphasizes the need for incorporating hormonal status into prognostic assessments and treatment planning for meningioma patients. Moreover, the prognostic utility of frailty in predicting surgical outcomes for primary brain tumor patients has been explored, indicating that frailty may serve as a significant predictor of postoperative complications and recovery (ref: Alare doi.org/10.1016/j.wneu.2024.08.003/). Additionally, the systematic review of olfactory groove meningiomas highlighted the necessity for objective assessments of olfactory function and quality of life, advocating for a more comprehensive approach to evaluating treatment outcomes (ref: Khan doi.org/10.1007/s10143-024-02708-2/). These findings collectively underscore the importance of integrating histopathological and prognostic factors into clinical practice to enhance patient management and outcomes.

Neuro-oncology research continues to shed light on the complex interplay between treatment strategies and patient outcomes in meningiomas. A study investigating the targeting of MERTK in meningioma and schwannoma cells revealed that inhibiting this pathway could significantly reduce tumor proliferation and enhance survival, suggesting a novel therapeutic avenue (ref: Dave doi.org/10.1038/s41388-024-03131-z/). This finding highlights the importance of exploring molecular targets to improve treatment efficacy in neuro-oncology. Additionally, the implementation of PET/CT in radiation oncology has been analyzed to identify patterns of care that enhance interdisciplinary collaboration and optimize treatment protocols (ref: Wegen doi.org/10.1007/s00066-024-02260-4/). The surgical outcomes of sinodural meningiomas have also been evaluated, emphasizing the unique challenges presented by their anatomical location and the need for tailored surgical approaches (ref: Birua doi.org/10.1016/j.jocn.2024.110804/). These studies collectively underscore the importance of integrating molecular insights, advanced imaging techniques, and personalized surgical strategies to improve patient outcomes in neuro-oncology.