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Background: Minimally invasive radical hysterectomy has been reported to increase the risk of cancer relapse and death compared with open surgery in women with early‐stage cervical cancer. The use of a uterine manipulator is considered one of the risk factors. Objectives: To investigate whether women with early‐stage cervical cancer treated with minimally invasive radical hysterectomy without using uterine manipulator have oncological outcomes similar to those of open surgery. Search strategy: Searches were performed in MEDLINE, Embase and CENTRAL from their inception until 31 March 2022. Selection criteria: Inclusion criteria were: (1) randomised controlled trials or observational cohort studies published in English, (2) studies comparing minimally invasive radical hysterectomy without using a uterine manipulator with open radical hysterectomy in women with early‐stage cervical cancer, and (3) studies comparing survival outcomes. Data collection and analysis: Two authors independently conducted data extraction and assessed study quality. We calculated the hazard ratios (HR) and the 95% confidence intervals (CI) using the inverse variance approach for survival outcome. Main results: Six observational studies with 2150 women were included. The minimally invasive surgery group had a significantly higher risk of cancer relapse compared with open surgery group (HR 1.55, 95% CI 1.15–2.10). Conclusions: Minimally invasive radical hysterectomy without using a uterine manipulator resulted in an inferior recurrence‐free survival compared with open radical hysterectomy in the treatment of women with early‐stage cervical cancer. [ABSTRACT FROM AUTHOR]

There are two main molecules in asymmetric unit of the title compound, C 27 H 21 N 3 O 6 ·0.5C 2 H 5 OH. In both, the indole ring systems are approximately perpendicular to each other, at dihedral angles of 69.3 (5) and 82.8(4)°. In the crystal, mol-ecules are linked by N-H⋯O and O-H⋯O hydrogen bonds into a three-dimensional supra-molecular architecture. The solvent ethanol mol-ecule acts as a donor, forming an O-H⋯O hydrogen bond, reinforcing the structure., (© Li et al. 2021.)