Introduction: The number of elderly patients with lung cancer undergoing thoracic surgery with curative intent has been increasing. However, postoperative complications remain higher than in younger patients, and although understudied due to lack of comparative studies, decreasing their incidence is an important goal.

Aim: To review our experience with surgical factors and postoperative outcomes in this particular population.

Materials and methods: One hundred and fifty two elderly lung cancer patients (122 men and 30 women with a median age of 82 years (range 77-86 years) who underwent surgery with a curative intent were retrospectively studied; preoperative and postoperative clinical data, surgical procedures, lung cancer staging, Charlson Comorbidity Index, morbidity and mortality, were collected.

Results: Preoperative comorbidities were observed in all patients (CCI was >2), postoperative morbidity was observed in 60 (40%), while 30 days mortality was observed in 2% and 90 days mortality in 4%. Sublobar resections and shorter surgical times were associated with less complications and better outcomes.

Conclusions: Although lung cancer surgery with curative intent in the elderly raises concerns about postoperative morbidity and mortality, it is a feasible treatment modality in carefully selected patients. Quality of surgery is an important factor in decreasing postoperative complications.