Embodiments predict biochemical recurrence (BCR) or metastasis by accessing a set of images of a region of tissue demonstrating cancerous pathology, including a tumor region and a tumor adjacent benign (TAB) region, the set of images including a first stain type image, and a second stain type image; segmenting cellular nuclei represented in the first and second image; generating a combined feature set by extracting at least one feature from each of a tumor region and TAB region represented in the first image, and a tumor region and TAB region represented in the second image, providing the combined feature set to a machine learning classifier; receiving, from the classifier, a probability that the region of tissue will experience BCR or metastasis; and generating a classification of the region of tissue as likely to experience BCR or metastasis, or unlikely to experience BCR or metastasis.