Table VI.
Module 4-Potential advantages, disadvantages, and limitations
| Statements voted upon | No. of votes | Voting, % | Most common response | No. of rounds | Consensus, % |
|---|---|---|---|---|---|
| Consensus reached | |||||
| Fluorescent imaging for SLN identification has the potential to significantly change gastric cancer surgery practice. | 19 | 86.4 | Agree | 1 | 94.7 |
| FIþICG makes SLN dissection feasible (doable and useful) laparoscopically (as a single agent or as part of a dual-agent regimen). | 21 | 95.5 | Agree | 1 | 90.5 |
| FIþICG improves SLN accuracy over standard agents (as a single agent or as part of a dual-agent regimen). | 19 | 86.4 | Agree | 1 | 89.5 |
| FIþICG improves SLN sensitivity over standard agents (as a single agent or as part of a dual-agent regimen). | 18 | 90.0 | Agree | 2 | 88.9 |
| Increased operating time is a significant limitation of using FI during gastric cancer surgery. | 21 | 95.5 | Disagree | 1 | 85.7 |
| Inadequate empirical evidence supporting efficacy is a major barrier to performing FI during gastric cancer surgery. | 21 | 95.5 | Agree | 1 | 85.7 |
| Equipment unavailability is a major barrier to using fluorescence imaging during gastric cancer surgery. | 18 | 90.0 | Agree | 2 | 83.3 |
| Fluorescent molecules are needed that specifically target either lymph node (eg, tilmanocept) or tumoral binding sites before SLN identification can become standard of care for gastric cancer. | 20 | 90.9 | Agree | 1 | 80.0 |
| Fluorescent imaging for SLN identification is necessary for all gastric cancer surgery. | 21 | 95.5 | Disagree | 1 | 76.2 |
| Regulatory issues are a major barrier to using fluorescence imaging during gastric cancer surgery. | 19 | 95.0 | Disagree | 2 | 73.7 |
| Identifying suitable surgical candidates who might benefit from FI is a major barrier to its use during gastric cancer surgery. | 19 | 95.0 | Disagree | 2 | 73.7 |
| No consensus reached | |||||
| Background fluorescence is a significant disadvantage of using FI during gastric cancer surgery. | 19 | 95.0 | Agree | 2 | 68.4 |
| FIþICG improves SLN specificity over standard agents (as a single agent or as part of a dual-agent regimen). | 18 | 90.0 | Agree | 2 | 66.7 |
| Fluorescence angiography significantly impacts the way that gastric cancer surgery is performed. | 18 | 90.0% | Agree | 2 | 61.1 |
| Inadequate fluorescence and the need for repeat dosing is a major limitation of FI during gastric cancer surgery. | 19 | 95.0% | Agree | 2 | 57.9 |
Average consensus = 78.4%.
FI, fluorescence imaging; ICG, indocyanine green; NIR, near-infrared; SLN, sentinel lymph node.