Ali BA, et al. - Pediatric osteosarcoma cases (38) treated between 2001 and 2012 at a single institution in Lebanon were analyzed in this retrospectively review to determine clinical features and outcomes of this disease condition, with a dramatic improvement in outcomes over the past few decades. Including cisplatin, doxorubicin, and methotrexate, a uniform three-drug chemotherapy regimen was used to treat all patients. In the presence of metastatic disease and/or poor degree of tumor necrosis (< 90%), the addition of ifosfamide and etoposide to the adjuvant treatment regimen was done. A median follow-up of 61 months revealed nearly 81% and 68% of 5-year overall and event-free survival rates, respectively, for localized disease, and they were approximately 42% for metastatic disease. The long bones around the knee were most commonly primarily affected. The survival achieved with the treatment of pediatric osteosarcoma in a multidisciplinary cancer center in Lebanon was similar to that reported in developed countries. Worse outcome was evident in relation to delay in local control. Poor degree of necrosis at the time of local control was the only statistically significant inferior outcome predictor that was identified in this study.