Table 3 Univariable and multivariable analysis Univariable Multivariable 95% CI 95% CI HR P-value Lower Upper HR P-value Lower Upper Overall survival  Sex (male) 1.508 0.322 0.669 3.397 2.438 0.092 0.865 6.871  Age (continuous) 1.026 0.161 0.990 1.063 1.017 0.395 0.978 1.058  Myasthenia gravis (yes) 0.234 0.019 0.069 0.790 0.551 0.459 0.114 2.666  TC vs thymoma 6.315 0.000 2.652 15.040 6.506 0.002 1.956 21.646  Incomplete resection 3.916 0.001 1.727 8.882 6.696 0.003 1.944 23.060  Pleural surgery   Primary pleural surgery vs pleural surgery for recurrencea 4.392 0.017 1.302 14.813 1.493 0.603 0.330 6.757  Type of pleural surgery   EPP vs LP + TP 2.351 0.040 1.041 5.312 2.491 0.122 0.784 7.913  Preoperative therapy (yes)b 3.086 0.013 1.271 7.463 1.495 0.427 0.554 4.032  Postoperative therapy (yes)c 2.558 0.030 1.093 5.988 1.733 0.293 0.622 4.831 Cause-specific survival  Sex (male) 1.740 0.331 0.569 5.325 3.206 0.128 0.715 14.372  Age (continuous) 1.041 0.108 0.991 1.093 1.039 0.197 0.980 1.101  Myasthenia gravis (yes) 0.022 0.110 0.000 2.387 0.000 0.952 0.000 171.39  TC vs thymoma 12.129 0.000 3.867 38.044 13.144 0.001 2.726 63.370  Incomplete resection 2.004 0.255 0.606 6.628 2.053 0.387 0.402 10.487  Pleural surgery   Primary pleural surgery vs pleural surgery for recurrencea 2.198 0.239 0.593 8.130 1.213 0.836 0.194 7.576  Type of pleural surgery   EPP vs LP + TP 2.301 0.155 0.729 7.265 1.063 0.934 0.252 4.488  Preoperative therapy (yes)b 2.179 0.180 0.697 6.803 1.072 0.914 0.593 3.788  Postoperative therapy (yes)c 2.066 0.203 0.675 6.329 1.020 0.976 0.288 3.613 Freedom from recurrenced  Sex (male) 1.541 0.096 0.926 2.566 1.800 0.033 1.050 3.086  Age (continuous) 1.007 0.523 0.985 1.031 1.009 0.504 0.983 1.036  Myasthenia gravis (yes) 0.623 0.090 0.361 1.077 0.661 0.208 0.346 1.260  TC vs thymoma 2.748 0.006 1.330 5.676 2.442 0.027 1.106 5.388  Pleural surgery   Primary pleural surgery vs pleural surgery for recurrencea 1.138 0.629 0.002 1.919 1.131 0.676 0.633 2.024  Type of pleural Surgery   EPP vs LP + TP 1.491 0.165 0.849 2.618 1.467 0.241 0.773 2.784  Preoperative therapy (yes)b 0.852 0.542 0.508 1.427 0.577 0.068 0.319 1.042  Postoperative therapy (yes)c 0.750 0.270 0.450 1.250 0.849 0.578 0.476 1.513 TC: thymic carcinoma; LP: local pleurectomy; TP: total pleurectomy; EPP: extrapleural pneumonectomy. a Analysis of primary pleural surgery versus pleural surgery for recurrence. b Patients received (pseudo-)neoadjuvant therapy, including chemotherapy ± radiotherapy. c Patients received (pseudo-)adjuvant therapy, including chemotherapy ± radiotherapy. d Freedom from recurrence was analysed only for patients after R0 resection.