Evidence map›Paper›PMID 40016616›Full record

Trial reportAnnals of surgical oncology2025

Economic Evaluation of Inguinal Versus Ilio-inguinal Lymphadenectomy for Patients with Stage III Metastatic Melanoma to Groin Lymph Nodes: Evidence from the EAGLE FM Randomized Trial.

Rashidul Alam Mahumud, Chi Kin Law, Daniel Ariza Ospino, Johannes H W de Wilt, Barbara L van Leeuwen, Chris Allan, Vinicius de Lima Vazquez, Rowan Pritchard Jones, Julie Howle, Barbara Peric and 2 more

Erratum issued Registry-linked trialAbstract readRandomized Controlled TrialComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT02166788 (Inguinal or Ilio-inguinal Lymphadenectomy for Patients With Metastatic Melanoma to Groin Lymph Nodes and no Evidence of Pelvic Disease on PET/CT Scan - A Randomised Phase III Trial), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02166788 phase3completednot on this map

Inguinal or Ilio-inguinal Lymphadenectomy for Patients With Metastatic Melanoma to Groin Lymph Nodes and no Evidence of Pelvic Disease on PET/CT Scan - A Randomised Phase III Trial (EAGLE FM)

TypeinterventionalSponsorMelanoma and Skin Cancer Trials LimitedRan2015 to 2024Enrolled634ConditionsMetastatic Melanoma to the Groin Lymph NodesArmsInguinal Lymphadenectomy, Ilio-inguinal Lymphadenectomy
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Rashidul Alam MahumudNHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
Chi Kin LawNHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
Daniel Ariza OspinoMelanoma and Skin Cancer Trials Limited, Melbourne, VIC, Australia.
Johannes H W de WiltDepartment of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Barbara L van LeeuwenDivision of Surgical Oncology, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Chris AllanFaculty of Medicine, Mater Clinical School, University of Queensland, Brisbane, QLD, Australia.
Vinicius de Lima VazquezMolecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil.
Rowan Pritchard JonesDepartment of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.
Julie HowleSydney Medical School, The University of Sydney, Camperdown, NSW, Australia.
Barbara PericInstitute of Oncology Ljubljana, Zaloska 2, 1000, Ljubljana, Slovenia.
Andrew J SpillaneSydney Medical School, The University of Sydney, Camperdown, NSW, Australia.
Rachael Lisa MortonNHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia. rachael.morton@sydney.edu.au.

Funding

Cancer Council NSW Project Grant RG15-06
6 · The paper itself

Abstract

purposeWe compared health outcomes and costs of inguinal lymphadenectomy (IL) versus ilio-inguinal lymphadenectomy (I-IL) for removal of metastatic melanoma to lymph nodes of the groin in adults with stage III melanoma.

methodsA within-trial cost-utility analysis was performed alongside an international randomized trial (EAGLE-FM) with 36 months follow-up from a health system perspective. Healthcare costs were measured by using trial records, and effectiveness measured in quality-adjusted life years (QALYs). Deterministic sensitivity analyses assessed the impact of changes in costs or quality of life on overall results. Statistical bootstrapping was employed to estimate confidence intervals around the cost-utility ratio.

resultsAmong 98 trial participants (IL n = 50, I-IL n = 48), with no pelvic or distant disease clinically or on PET/CT imaging, the mean life years saved for those randomized to IL showed a small but nonsignificant increase of 0.05 years compared with those in the I-IL group (2.56 vs. 2.51 years, 95% confidence interval [CI] -0.78 to 0.87). The mean difference in QALYs gained showed a small but nonsignificant increase of 0.04 QALYs (1.95 vs. 1.91, 95% CI -0.49 to 0.57). The mean hospital stay among IL patients was 6.16 days, 1.24 days shorter than I-IL patients (7.40 days) at 36 months follow-up. Mean per-patient healthcare costs of IL surgery were AU$6938 lower than for I-IL surgery ($26,555 vs. $33,493, 95% CI -$24,360 to $10,484). Inguinal lymphadenectomy was slightly more effective and slightly less expensive) over I-IL; a finding supported by 81% of bootstrapped estimates and upheld across sensitivity analyses.

conclusionsOur study indicates that less extensive IL surgery might be the preferred surgical strategy for metastatic melanoma to the groin when PET/CT imaging shows no pelvic disease. This surgery is likely to improve quality-adjusted survival and may reduce healthcare costs; however, the differences noted in EAGLE-FM were limited by a small sample size and were not statistically significant.

trial registrationClinicaltrials.gov NCT02166788; anzctr.org.au ACTRN12614000721606.

Indexed as

Health Care CostsIliumInguinal CanalLymph Node ExcisionLymph NodesMelanomaSkin NeoplasmsAdultAgedCost-Benefit AnalysisFemaleFollow-Up StudiesGroinHumansLymphatic MetastasisMaleCost-utility analysisIlio-inguinal lymphadenectomyInguinal lymphadenectomyMelanomaQuality-adjusted life yearsRandomized controlled trials

Identifiers

PMID40016616
PMCPMC12049375

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.