Analysis of OS at 3, 5 and 10 years revealed statistically significant differences between primary pleural surgery and surgery for pleural recurrence (P = 0.028, P = 0.023, P = 0.027, respectively). Comparably, the analysis of OS at 3, 5 and 10 years revealed statistically significant differences between complete and incomplete resections: R0 vs R1/R2 (P = 0.032, P = 0.003, P = 0.001, respectively). While there were no statistically significant differences in FFR for the type of surgery: EPP vs TP vs LP, there were differences in OS [1-year: P = 0.010], DFS [3-year: P = 0.021 and 5-year: P = 0.037] and CSS [1-year: P = 0.012 and 3-year: P = 0.041]. The calculation of OS, DFS, CSS and FFR for thymomas versus TCs at 1, 3, 5 and 10 years revealed statistical significance for all analysis. Analysis of OS and CSS revealed a statistically significant survival advantage for patients with MG (10-year OS: P = 0.010; the 5 and 10-year CSS: P = 0.047 and P = 0.014, respectively; Fig. 4 and Supplementary Material, Table S6). In non-EPP patients with pericardial resection (n = 52), there was significantly worse survival at 10 years (OS at 1, 3, 5 and 10 years for pericardial resection yes (n = 52) vs no (n = 52): 98.0% vs 100.0% (P = 0.322), 93.3% vs 100.0% (P = 0.082), 86.7% vs 97.0% (P = 0.082), and 55.1% vs 87.2% (P = 0.010), respectively.