In summary, complete surgical resection is the mainstay for treatment of patients with TETs even in Masaoka–Koga Stage IVA. The type of resection, i.e. EPP, TP, LP, is dependent from the extent and distribution of tumour. However, even in more advanced tumour situations with the combination of pleural and intraparenchymal tumour spread, EPP provides equally as good results as the less complex procedures (TP or LP) for pleural metastasis only.