I read it as the latter. 100% of those who failed had pattern 4, not 100% of those who failed and had non-organ confined disease had pattern 4.
Doing a little math, here's what I get. Be careful in what you conclude, the sample size of recurrances is quite small - only 5 people.
124 out of 339 people in the sample had high PSAV (> 0.35)
19 of these had some pattern 4.
5 of the 124 people in the HIgh PSAV group progressed, all of whom had some pattern 4. (4% of the high PSAV group)
That means 14 people with high PSAV had some pattern 4 and yet did not progress.
So, knowing only this, if you fit the population of low psa, non-palpable, high PSAV and some pattern 4 you have 26% chance of progression. Of course, the numbers are very small and probably not significant at this stage.
67% of the progressors had non-organ confined disease (OCD).
That means 3 progressors had non-OCD.
Of all the high PSAV people, 10 had non-OCD.
So seven of the 10 high PSAV people had non-OCD and yet did not progress.
so knowing only this, if you fit the population (low PSA, non palpable, high PSAV, non-OCD) you have a 30% chance of progression and a 70% change of being ok.
Of course, some of the people with non-OCD are also Pattern 4, and we have no way of knowing given the data presented.
It's theoretically possible that if you are high PSAV, pattern 4 but OCD you are ok, and if you are high PSAV, no pattern 4 but not OCD, that you are also ok. The devil may lie in the combination of gleason 4 and non-OCD. But we have no way of knowing that from the data presented.
Does my math hold up?
You could always send an email to the authors asking for more explanation.
If you are interested in more on PSAV you might want to check these articles, which I posted in another earlier thread:
"Among the 852 consecutive patients in our series2 (1989 to 2002; median follow-up, 3.4 years [range, 0.4 to 14.6]) and who met the eligibility criteria of D'Amico et al., a PSA velocity of more than 2.0 ng per milliliter per year was associated with more advanced clinical and pathological stages, but not with recurrence of cancer or a reduction in overall survival. The probability of death from any cause at seven years was 7 percent (95 percent confidence interval, 5 to 9 percent) among those with a PSA velocity of 2.0 ng per milliliter per year or less and 7 percent (95 percent confidence interval, 2 to 13 percent) among those with a PSA velocity of more than 2.0 ng per milliliter per year.” Source: Bianco, Kattan, Scardino in JAMA www.nejm.org/doi/full/10.1056/NEJM200410213511723
Pretreatment Prostate-Speciﬁc Antigen (PSA) Velocity and Doubling Time Are Associated With Outcome but Neither
Improves Prediction of Outcome Beyond Pretreatment PSA Alone in Patients Treated With Radical Prostatectomy
Matthew Frank O’Brien, Angel M. Cronin, Paul A. Fearn, Brandon Smith, Jason Stasi, Bertrand Guillonneau,
Peter T. Scardino, James A. Eastham, Andrew J. Vickers, and Hans Lilja
Urology. 2007 May;69(5):931-5. Assessment of prostate-specific antigen doubling time in prediction of prostate cancer on needle biopsy. Spurgeon SE, Mongoue-Tchokote S, Collins L, Priest R, Hsieh YC, Peters LM, Beer TM, Mori M, Garzotto M. which found: "In contrast to its prognostic value after the diagnosis of prostate cancer has been established, PSA kinetics offer little to clinical decision making as predictors of cancer or high-grade cancer in men with a PSA level of 10 ng/mL or less."
Post Edited (proscapt) : 12/16/2010 4:28:50 PM (GMT-7)