Updated Systematic Review on the Role of Brain Invasion in Intracranial Meningiomas: What, When, Why?

Abstract

Several recent studies are providing increasing insights into reliable markers to improve the diagnostic and prognostic assessment of meningioma patients. The evidence of brain invasion (BI) signs and its associated variables has been focused on, and currently, scientific research is investing in the study of key aspects, different methods, and approaches to recognize and evaluate BI. This paradigm shift may have significant repercussions for the diagnostic, prognostic, and therapeutic approach to higher-grade meningioma, as long as the evidence of BI may influence patients’ prognosis and inclusion in clinical trials and indirectly impact adjuvant therapy. We intended to review the current knowledge about the impact of BI in meningioma in the most updated literature and explore the most recent implications on both clinical practice and trials and future directions. According to the PRISMA guidelines, systematic research in the most updated platform was performed in order to provide a complete overview of characteristics, preoperative applications, and potential implications of BI in meningiomas. Nineteen articles were included in the present paper and analyzed according to specific research areas. The detection of brain invasion could represent a crucial factor in meningioma patients’ management, and research is flourishing and promising.

Differences in intraoperative sampling during meningioma surgery regarding CNS invasion – Results of a survey on behalf of the EANS skull base section

“…Regarding the intraoperative assessment, the majority of study participants agreed with the statement that CNS invasion can be detected during resection. So far, no convincing data is available to confirm this perception ( Brunasso et al., 2022 ). One retrospective study suggests a large discordance between intraoperative signs of invasion and true histopathological invasion ( Behling et al., 2020b ).…”

Type IV collagen-derived angiogenesis inhibitor: canstatin low expressing in brain-invasive meningiomas using liquid chromatography–mass spectrometry (LC-MS/MS)

“…It has been documented that BI in meningioma is correlated to molecular alterations at various cellular components and in signal transmission pathways [ 23 ]. Such alterations result in three-step process, initially degradation of ECM/BM, and tumor cells migration, finally promoting adhesion of meningioma cells to resident cells with the help of growth factors and blood-vessel formation [ 24 ], leading to the tendency of the tumor to infiltrate and local BI.…”