Background and Objectives: Prostate cancer (PC) is largely a disease of elderly men, and de novo metastatic presentations are increasingly reported in this population. Yet older patients remain underrepresented in clinical trials, limiting the applicability of guideline-based treatments. Materials and Methods: We retrospectively analyzed 90 patients aged ≥75 years with de novo metastatic castration-sensitive PC (mCSPC) to describe clinical features, treatment patterns, and survival outcomes. Results: Median age was 81 years; high-volume disease and Gleason grade 9–10 tumors predominated. A substantial portion of patients received androgen deprivation therapy (ADT) alone or with bicalutamide despite recommendations for intensified therapy. Enzalutamide was associated with the longest median progression-free survival (PFS, 25.4 months) and overall survival (OS, 30.5 months), though between-group differences were not significant. Castration resistance occurred only in the high-volume group (22.4%). Absence of hypertension was associated with a lower risk of progression (HR 0.46, 95% CI 0.23–0.92, p = 0.028). Conclusions: Elderly patients with de novo mCSPC often have aggressive forms of the disease. Enzalutamide was associated with numerically longer survival compared to other treatments, although the difference was not statistically significant. Additionally, the absence of hypertension appeared to be linked with a lower risk of progression, suggesting that comorbid conditions such as hypertension may influence treatment outcomes in elderly patients.

Background/Objectives: The optimal adjuvant chemotherapy regimen remains uncertain for some patients with hormone receptor (HR)-positive/HER2-negative early breast cancer, particularly regarding the incremental benefit of anthracyclines. We compared real-world outcomes with docetaxel-plus-cyclophosphamide (TC) and anthracycline–taxane chemotherapy. Methods: This retrospective single-center cohort included patients with stage I–III HR-positive/HER2-negative breast cancer who underwent surgery and received adjuvant TC or anthracycline–taxane chemotherapy between 2019 and 2025. Patients receiving neoadjuvant systemic therapy were excluded. Disease-free survival (DFS) was the primary outcome and overall survival (OS) the secondary outcome. Propensity score overlap weighting adjusted for measured baseline differences was used; the absolute difference in weighted 3-year DFS was the primary adjusted measure. Results: Among 361 patients, 201 received TC and 160 anthracycline–taxane chemotherapy. The anthracycline–taxane group had higher baseline clinicopathologic risk. Median follow-up was 39.0 months. Twelve DFS events occurred (TC, n = 3; anthracycline–taxane, n = 9). Unadjusted 3-year DFS was 99.0% versus 96.6% (p = 0.096), and 3-year OS was 99.4% versus 99.1% (p = 0.725). The overlap-weighted analysis included 346 patients and achieved adequate covariate balance. Weighted 3-year DFS was 99.2% with TC and 96.5% with anthracycline–taxane chemotherapy, an absolute difference of 2.68 percentage points (95% CI, −1.81 to 10.03). Sensitivity analysis yielded similar results (2.70 percentage points; 95% CI, −1.76 to 9.87). Conclusions: No statistically significant difference in 3-year DFS was demonstrated after adjustment. Limited events and relatively short follow-up preclude conclusions regarding equivalence or noninferiority. These findings support individualized adjuvant chemotherapy selection and warrant confirmation in larger cohorts with longer follow-up.

Metastatic endometrial cancer carries a poor prognosis. Accurate prognostic tools are lacking. Machine learning (ML) may improve survival prediction using available clinicopathological and sociodemographic data. We analyzed 11,720 patients with metastatic endometrial cancer from the SEER database. The primary outcome was two-year overall survival (OS). Thirteen ML classifiers were trained (70/30 split) and evaluated using AUC, accuracy, and F1 score. SMOTE and calibration analysis were applied to the best-performing model. Kaplan–Meier, Cox regression, and SHAP-based interpretability analyses were performed. XGBoost achieved the highest AUC (0.726). Following SMOTE, F1 improved from 0.446 to 0.516 (AUC 0.715), with a calibration intercept and slope of -0.097 and 0.941, respectively. SHAP analysis identified histologic subtype and chemotherapy receipt as the most influential predictors, followed by tumor grade, age, and race/ethnicity. On multivariate Cox regression, Grade IV (HR 2.08), undifferentiated histology (HR 1.97), age ≥ 80 years (HR 1.71), and Non-Hispanic Black race (HR 1.35) were independently associated with worse OS; chemotherapy receipt was associated with improved observed survival (HR 0.43). Kaplan–Meier analysis confirmed significant differences in overall survival by histologic subtype and chemotherapy status (log-rank p < 0.001 for both). ML models using registry-based data predict two-year OS in metastatic endometrial cancer with modest but consistent performance. Histologic subtype, chemotherapy, tumor grade, and age are important predictors of survival. Racial disparities in survival persisted after adjustment, underscoring the need for targeted interventions to address healthcare inequities.