Unfavorable Pathology, Tissue Biomarkers and Genomic Tests With Clinical Implications in Prostate Cancer ManagementNguyen, Jane Kim, MD, PhD*; Magi-Galluzzi, Cristina, MD, PhD*,†Advances in Anatomic Pathology: September 2018 - Volume 25 - Issue 5 - p 293–303 doi: 10.1097/PAP.0000000000000192 Review Articles Abstract Author Information Prostate cancer management has traditionally relied upon risk stratification of patients based on Gleason score, pretreatment prostate-specific antigen and clinical tumor stage. However, these factors alone do not adequately reflect the inherent complexity and heterogeneity of prostate cancer. Accurate and individualized risk stratification at the time of diagnosis is instrumental to facilitate clinical decision-making and treatment selection tailored to each patient. The incorporation of tissue and genetic biomarkers into current prostate cancer prediction models may optimize decision-making and improve patient outcomes. In this review we discuss the clinical significance of unfavorable morphologic features such as cribriform architecture and intraductal carcinoma of the prostate, tissue biomarkers and genomic tests and assess their potential use in prostate cancer risk assessment and treatment selection. *Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic †Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH The authors have no conflicts of interest to disclose. Reprints: Cristina Magi-Galluzzi, MD, PhD, Pathology and Laboratory Medicine Institute, Cleveland Clinic, 9500 Euclid Avenue, L25, Cleveland, OH 44195 (e-mail: firstname.lastname@example.org).All figures can be viewed online in color at www.anatomicpathology.com. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.