Freedland SJ, et al. - Given that the decision making regarding postoperative radiation or multi-modal therapy after radical prostatectomy (RP) relies on accurate risk stratification, researchers assessed Decipher genomic classifier (GC) in a high-risk cohort of 557 patients who underwent RP at the VA Medical Center Durham between 1989 and 2016. Its performance was compared to that of the CAPRA-S clinical model for predicting outcomes. The cohort was comprised of 306 African-American men (AAM) patients (55%). By CAPRA-S and GC, 10.4% and 50.4%, respectively, were classified as low risk for recurrence. Metastasis within non-AAM was significantly predicted by both GC and CAPRA-S in multivariable analyses, but only GC was significant within AAM. The utility of GC as a powerful predictor of metastasis and PCa specific mortality (PCSM) was corroborated by results among non-AAM in this study. Poor outcome among AAM was strongly predicted by GC. A possible better performance of GC could be seen among AAM vs EAM.