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This multicenter retrospective cohort study involving 235 patients with medullary thyroid cancer (MTC) reports that nodal recurrence predominantly occurs in the ipsilateral central and lateral neck compartments, with contralateral central neck recurrence being rare. Among clinically node-negative (cN0) patients, contralateral prophylactic central neck dissection (pCND) did not significantly reduce recurrence rates, and multivariable analysis showed no clear association between contralateral pCND and reduced overall or contralateral neck recurrence. Given wide confidence intervals, larger studies are necessary to definitively determine the clinical benefit of contralateral pCND.
