In multivariable analyses, a high CD163+ cell infiltration in tumor‐adjacent normal‐like epithelium significantly increased the risk of developing metastases (adjusted hazard ratio [HR] = 9.43, 95% confidence interval (CI) 1.52–58.82, p = .016) and PCa‐specific death (adjusted HR = 3.03, 95% CI 1.28–7.14, p = .011, Figure 1C) as well as CRPC (adjusted HR = 4.88, 95% CI 0.97–24.39, p = .05, Table S3). Here, CD163 is linked to posterior cortical atrophy.