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: Liver biopsy remains the gold standard for staging chronic hepatitis B (CHB), yet it is invasive, costly, and associated with potential complications. There is a critical need for non-invasive, cost-effective biomarkers to monitor disease progression. This study aimed to evaluate the correlation between the Prognostic Nutritional Index (PNI) and Systemic Immune–Inflammatory Index (SII) with histological fibrosis stages and the Histological Activity Index (HAI) in patients with CHB. Methods: This retrospective study analyzed 274 patients diagnosed with CHB (HBsAg positivity > 6 months) who underwent liver biopsy at the University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital between February 2016 and February 2022. Histopathological findings were staged using the Ishak fibrosis score and HAI. PNI and SII were calculated from peripheral blood parameters. Statistical discrimination power was assessed using Area Under the Receiver Operating Characteristic (AUROC) curves. Results: The cohort comprised 119 females (43.4%) and 155 males (56.6%), with a mean age of 45.25 ± 11.2 years. Mean values were 55.83 ± 5.33 for PNI and 494.37 ± 336.86 for SII. Fibrosis distribution showed 56.2% at stages F0–F1 and 43.8% at ≥F2. For fibrosis staging, SII demonstrated statistically significant but limited predictive ability for Ishak scores ≥F2, while PNI was significant for identifying advanced fibrosis (≥F4) (p < 0.05). SII showed moderate diagnostic performance for severe inflammation (HAI ≥12; AUROC = 0.848), although this finding should be interpreted cautiously. For lower HAI thresholds (≥6), both PNI and SII demonstrated poor discriminative ability (AUROC 0.5–0.6). Conclusions: Both indices were associated with histological parameters but showed limited overall diagnostic performance. SII appeared relatively better; however, this was descriptively observed without formal statistical comparison. These markers may provide complementary information but should not be used as standalone diagnostic tools.