Clinicopathological characteristics and prognostic factors of diffuse infiltrating glioma in Morocco: A retrospective single-center institutional experience under the 2021 WHO classification.

Abstract

Gliomas are the most common primary malignant tumors of the central nervous system. Their incidence and survival vary across low/middle and high-income countries. This study summarizes the epidemiological, clinical, and therapeutic features of a Moroccan cohort, based on the WHO 2021 classification. We conducted a retrospective descriptive single-center study at the Mohammed VI Cancer Center in Casablanca, including 122 patients with diffuse infiltrating gliomas diagnosed between January 2019 and November 2024. Demographic, clinical, and therapeutic data were analyzed. Overall survival was assessed in 64 glioblastoma patients using Kaplan-Meier methods, log-rank tests, and Cox regression models. Among 122 patients, the median age was 56 years with a 2:1 male to female ratio. Glioblastoma was the predominant subtype (75%), localized predominantly in the parietal (31%), frontal (26%), and temporal (21%) lobes. The frequently observed symptoms were motor deficits, headaches, and seizures. For glioblastoma patients, the median OS was 9 months, with a 2-year survival rate of 27%. Younger age and multimodal treatment were associated with better outcomes, with treatment emerging as the only independent prognostic factor. Our institutional clinicopathological features align with international series, whereas overall survival stands lower. Patients receiving full multimodal therapy achieved survival profiles comparable to published international data, identifying treatment as a determinant of outcome in our setting. Expanded molecular testing and structured clinical follow-up represent potential strategies to optimize survival outcomes within our institutional context.