The emerging role of minimally invasive surgical techniques for the treatment of lung malignancy in the elderly.

As the population ages, increasing numbers of elderly patients will present with lung cancer. Due to recent advances in neoadjuvant therapies and accumulating data demonstrating a favorable risk/benefit relationship even in octogenarians, more of these geriatric patients will be surgical candidates. Although preoperative functional status and comorbidities seem to have more of an influence on outcome than age alone, the normal process of cardiopulmonary aging can serve to limit the physiologic reserve necessary to compensate for perioperative stress even in otherwise healthy elderly patients. Emerging experience now also suggests that minimally invasive surgical techniques for the treatment of lung cancer may parallel conventional thoracotomy in terms of oncologic efficacy while decreasing perioperative morbidity in the elderly.