Microvascular density and vasculogenic mimicry the predictive signatures of prognosis and therapeutic response in gliomas—a systematic review and meta-analysis protocol

Malignant gliomas are the most angiogenic aggressive tumours with high proliferative and invasion phenotypes. Total microvessel density, the combination of the microvascular density and the vasculogenic mimicry status, is a biomarker closely associated with the aggressiveness of a tumour including its invasive and metastatic potential. This review aims to investigate the relationship between vasculogenic mimicry and microvascular density, and its association with prognosis and therapeutic response in gliomas across the available randomized clinical trials (RCTs) and cross-sectional studies to optimize the strength of evidence for underpinning the strategy for treating tumours. We will conduct the Systematic and Meta-analysis by employing the provisions of Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) 2020 guideline and the review protocol will be submitted to International Prospective Register of Systematic Reviews (PROSPERO) for registration before commencement of the study. We will construct the search strategy using a combination of ‘glioma’, ‘microvascular density’, ‘vasculogenic mimicry’, ‘prognostic significance’ and ‘therapeutic response’ from the four databases (Scopus, EMBASE, PubMed and Cochrane Library). This review will be conducted without the involvement of human participants, making ethical clearance approval inapplicable. The protocol for this review will be duly registered with the PROSPERO registry. The final report of this review will be shared at scientific conferences, both locally and internationally, and the protocol and final results will be published in a reputable Neurosurgery journal.