TCs in comparison with thymomas at multivariable analysis had a negative impact on OS [HR 6.506; P = 0.002], CSS [HR 13.144; P = 0.001] and FFR [HR 2.442; P = 0.027], respectively. Further, incomplete resections predicted worse OS [HR 6.696; P = 0.003] and male sex predicted worse FFR [HR 1.800; P = 0.033] at multivariable analysis. In order to eliminate the potential strong bias of incomplete resection on other predictors, we also performed multivariable analysis only on patients after complete resection (R0): negative impact on OS male sex [HR 3.176; P = 0.025], TC [HR 3.988; P = 0.013], primary pleural surgery compared with surgery for pleural recurrence [HR 4.132; P = 0.040]; no effect was found for MG, age, type of surgery, preoperative or postoperative treatments. Analysis of multimodality therapy (all patients with [pseudo-]neo- and [pseudo-]adjuvant therapy combined: n = 126) vs surgery alone (n = 26) revealed no statistically significant differences.