State-of-Art on Multidisciplinary Approaches to Meningioma: A Systematic Review of the Available Evidence.

BACKGROUND

Meningiomas are the most common primary intracranial tumors, often requiring complex management due to their proximity to critical neurovascular and orbital structures. While surgery remains the cornerstone of treatment, achieving optimal outcomes requires coordinated efforts to balance tumor control with functional preservation. Multidisciplinary approaches have emerged as a strategy to enhance decision-making, integrate diverse expertise, and improve patient care. This study aims to synthesize the evidence and state-of-the-art knowledge on the multidisciplinary approach to meningiomas through a systematic review.

METHODS

This systematic review was conducted in accordance with PRISMA guidelines to evaluate how multidisciplinary approaches are implemented in the management of meningiomas. A comprehensive search of PubMed, Embase, the Cochrane Library, and Web of Science was performed from database inception to July 24, 2025. Eligible studies were English-language clinical investigations involving histologically confirmed meningiomas that explicitly reported multidisciplinary involvement in patient management. Extracted data included the composition of multidisciplinary teams, the roles and interactions of participating specialties, tumor management strategies, and authors' assessments of the impact of multidisciplinary decision-making on oncological, functional, and organizational outcomes.

RESULTS

Twenty studies encompassing 959 patients were included. Multidisciplinary participation was heterogeneous but consistently involved multiple specialties. Neurosurgeons were included in 18 studies (90%), ophthalmologists or neuro-ophthalmologists in 13 (65%), radiation oncologists in 11 (55%), and neuroradiologists in 7 (35%). Neurosurgeons primarily performed resections and intraoperative decision-making, while ophthalmology contributed to visual assessment and orbital reconstruction, radiation oncology guided adjuvant therapy, and neuroradiology provided imaging integration for surgical planning. A total of 15 studies (75%) endorsed multidisciplinary management, reporting measurable benefits such as improved or preserved visual function in 10 studies (50%), reduced morbidity in 5 (25%), and greater resource efficiency in 4 (20%). The strongest synergistic interactions were observed in neurosurgery-neuroradiology collaborations (7 studies, 35%), which enhanced resection precision, and neurosurgery-ophthalmology partnerships (10 studies, 50%), which optimized visual outcomes.

CONCLUSION

Multidisciplinary management of meningiomas has evolved from an optional collaboration into a fundamental principle of modern neuro-oncologic care. Integrating diverse expertise enhances tumor control, preserves neurological and visual function, and optimizes patient quality of life. The future of meningioma management is one where success is measured not solely by the extent of resection, but by the harmony of function, form, and long-term well-being achieved through team-based care.