But with Ireland 49 ahead in points difference before play began, a Leonardo Sarto interception and two Luciano Orquera penalties proved vital in preventing Lancaster's troops from overhauling the men in green.
The victory does keep their title hopes alive however with everything to be decided in Paris this evening when Ireland travel to France.
A draw or a defeat for Ireland - as long as France don't win by 71 points - would give Lancaster the first RBS 6 Nations crown of his reign and a first for England since 2011.
But the head coach was only reflecting on a job well done in Italy, even if he allowed himself a moment to ponder the what ifs of their opening defeat to France that has denied them a Grand Slam.
"Everything matters in a game and we've scored some great tries and come here and scored 50 points, which not many teams do. I'm proud of the boys," he said.
"We weren't quite right in the first half. There were some errors there and the team wasn't right in the first half on occasions. But I'm proud of the boys - it's a great squad we've got and they're doing an important job.
"You have to take the opportunities when they're there but that's the game of rugby. Italy are a very proud side who are playing in their home stadium so won't give up easily.
"The last ten minutes against France are very frustrating, as are the first five. We are 16-3 down in that game. We played tremendously well in that one and almost came back and deserved to win it.
"But overall you have to look at the bigger picture. The Scotland performance, the Ireland one and the Wales performance…I don't think any other team have scored as many tries as us. You've got be proud of the boys."