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As pathology has moved toward subspecialization in most major medical institutions in the United States, the detail of pathological diagnoses has also expanded in line with medical treatment parameters. Several studies have now demonstrated significant diagnostic changes in urologic pathology specimens when re-reviewed by a subspecialist [110], highlighting the critical need for advanced training. Subtyping of cancers to identify those that harbor distinct molecular andor morphological features associated with behavior or response to drug therapy is also becoming mainstream practice, with many sites expanding in-house genomic test panels. The combination of accurate diagnostic reads and availability of molecular testing are two crucial parameters in the design and successful implementation of emerging clinical trials.

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