Background Gastrointestinal malignancies constitute the most common neoplasms with increasing prevalence worldwide, which portend a dismal morbidity and higher mortality rate. Epigenetic phenotypes and field cancerization impute a cutting edge for precursor of several gastrointestinal malignancies, this genetic aberration have been critically implicated in tumorigenesis and recurrence of gastrointestinal malignancies. There has been a paucity of knowledge about the interface effect between epigenetic signatures, epigenetic phenotype and field cancerization for carcinogenesis and recurrence of disease, a comprehensive analysis on the interplay of these biomarkers would streamline the strategy for epigenetic screening and chemoprevention therapy of gastrointestinal malignancy. This systematic review aims at assessing the effect of epigenetics and field cancerization on carcinogenesis and recurrence of gastrointestinal malignancies. Methods and Analysis This Systematic review and Meta-analysis will administer the provisions of Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) 2020 guideline and the review protocol will be submitted to PROSPERO review registry for registration. The literature search will be executed through several electronic databases including EMBASE, PubMed, Scopus, Web of Science, Cochraine , Global index medicus , semantic scholar and google scholar . All original research articles reporting on the effect of epigenetic signatures, epigenetics and field cancerization on the carcinogenesis and recurrence of gastrointestinal cancers in adults will be included. Only articles with NOS score above 4 and Low ROB based on D1-D5 for RCTs will be included for a Meta-analysis. Ethical Consideration and Dissemination There is no involvement of human subject participation in this review thus giving no effect to ethical implication .The evidence report of this review will be disseminated on scientific conferences and will be published to a reputable journal of gastroenterology oncology. This review has been registered at PROSPERO registry ID CRD 42023391339

Background Gliomas are the most common solid malignant tumors of the brain; diffuse gliomas pose a remarkable conundrum on treatment strategy. WHO Grade IV (Glioblastomas) delineate a refractory resistance to treatment even with standard combination regimen therapy of surgery, chemotherapy and radiation therapy causing increased recurrence rate with a median survival of less than one year(1). Management of gliomas is precluded by several factors including intra and inter tumoral heterogeneity, genomic landscape and microenvironment immunosuppression ability, which spell the inflicted pathways that counteract the therapeutic interventions. This is systematic review aiming to evaluate the effect of tumor mutation burden (TMB) and Tumor microenvironment (TME) as biomarkers of treatment outcome and prognosis of gliomas. Methods and Analysis This systematic Review and Meta –analysis will consider the PRISMA 2020 guideline correspondence. For source of literature evidence several electronic databases including EMBASE, PubMed, Cochrane Library, SCOPUS, Web of Science, Semantic Scholar and Google scholar will be searched. All non-RCTs peer reviewed original research articles addressing the prognostic role of tumor mutation burden, tumor mutation pathways, microenvironment will be included, and data will be extracted using the Ms Excel Sheets. Studies with homogeneity and low risk of bias according to NOS 4–9 will constitute a Meta-analysis for evaluating the effect of TMB, Mutation pathways and Microenvironment for treatment outcome and prognosis of glioma. Ethical Consideration and Dissemination Ethical approval does not apply for there is no human participant involvement in this review study .The findings of this study will be disseminated at scientific conferences and the manuscript for publication will be submitted for publication to a reputable peer reviewed journal of Neurosurgery. This review was registered at PROSPERO CRD42022377829