The experience accumulated in a 5-year period with the surgical treatment of lung cancer in the elderly is reviewed. The cases of 171 patients treated between December 1989 and November 1994, were evaluated retrospectively, according to a selected groups of parameters. Fifty patients underwent thoracotomy, and the recorded postoperative complications were analyzed. The most important factors for predicting complications were the oxygen partial pressure in the arterial blood (PO(2)), the forced expiratory volume/1 sec (FEV(1)), the seriousness of the surgical intervention, and the duration of general anesthesia. The correct selection of patients and an adequate treatment of complications may be crucial for the success of surgical therapy of elderly patient.