The aim of this study was to determine what factors beyond age affect post-operative mortality. We included 971 patients (mean age 61 +/- 10 years; 882 men, 89 women). There were 61 patients (6%) 75 years of age and over. Post-operative death rate was 15% in patients 75 and over versus 6% in patients under 75 (p = 0.01). Other variables significantly correlated with post-operative death after univariate analysis were: heart failure, Karnofsky score, VEMS, CV, PaCO2, tumor size, right side resection, pneumonectomy and large exeresis. Multivariate analysis retained 6 independent variables affecting post-operative mortality: age > or = 75 years (p = 0.019), Karnofsky score (p = 0.0001), right side resection (p = 0.0002, pneumonectomy (p = 0.04, large resection (p = 0.029) and hypocapnia (p = 0.01). If these parameters are considered when deciding on surgery, pulmonary exeresis may be proposed in elderly patients.