Introduction: The risk of lung cancer increases as individuals get older, as they are more susceptible due to exposure to factors such as smoking, air pollution, and weakened immune systems.

Aim and objectives: Analyze surgery outcomes for octogenarians with lung cancer, and to identify factors influencing the likelihood and outcomes of surgery.

Methods: A retrospective study of 26 patients (average age of 82) with lung cancer who underwent curative oncologic surgery in the thoracic surgery department of Abderrahmane Mami hospital in Ariana, Tunisia, from 2002 to 2022.

Results: 26 patients with lung cancer (25 NSCLC 1 SCL) with an age ranging from 80 to 89, including 24 men and 2 women and with various medical histories: hypertension (19%), diabetes (11%), COPD (7%), and coronary artery disease (7%). Only one patient was not a smoker. The main clinical symptoms observed were coughing(46%), chest pain(42%), and general deterioration (30%). Average FEV1 was 60%. All patients had a curative surgery: left upper lobectomy (23%), right upper lobectomy (23%), left lower lobectomy (26%), right lower lobectomy (10%), bilobectomy (8%), and pneumonectomy (8%). Lymph node dissection was performed in all cases. One patient received neoadjuvant chemotherapy, and 2 received adjuvant chemotherapy.The postoperative course of 18 patients was uncomplicated, while 8 experienced complications: arrhythmia (4), pneumonia (5). Three adverse events were recorded: 2 fatalities from septic shock and one revision surgery. The survival rate was 92%.

Conclusions: In octogenarian patients with lung cancer, the likelihood of surgery and outcomes may vary based on various factors including disease severity, comorbidity an treatment options.