Bone metastases, skeletal-related events, and survival among children with cancer in Denmark
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Updated: May 4, 2026
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Published on: October 14, 2016
Rohini K Hernandez1, Merete L Maegbaek, Alexander Liede
1*Center for Observational Research, Amgen Inc., Thousand Oaks, CA †Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.
Insights
Bone metastases are rare in pediatric cancer patients, affecting only 1.3% of children. However, skeletal-related events (SREs) are a frequent complication for those with bone metastases, impacting survival rates.
Area of Science:
- Pediatric Oncology
- Cancer Metastasis Research
- Skeletal Complications in Cancer
Background:
- Bone metastases and skeletal-related events (SREs) in children with cancer lack comprehensive population-based data.
- Understanding these complications is crucial for improving pediatric cancer care and patient outcomes.
Purpose of the Study:
- To investigate the incidence of bone metastases and SREs in a Danish pediatric cancer population.
- To analyze survival rates associated with bone metastases in children.
- To determine the frequency of SREs in pediatric cancer patients with bone metastases.
Main Methods:
- Utilized the Danish Cancer Registry and Danish National Registry of Patients for data extraction.
- Identified children under 18 with a first-time cancer diagnosis (1994-2009).
- Calculated incidence rates (IRs) and estimated survival using Kaplan-Meier curves.
Main Results:
- 35 out of 2652 children (1.3%) developed bone metastases (IR=1.9 per 1000 person-years).
- Incidence was higher in solid tumors (IR=3.2) than hematologic malignancies (IR=0.48).
- Children with bone metastases had poorer survival; 67% experienced an SRE (IR=590 per 1000 person-years).
Conclusions:
- Bone metastases are infrequent in pediatric cancer but significantly associated with reduced survival.
- Skeletal-related events (SREs) are a common and serious consequence for children with bone metastases.
- Further research is needed to mitigate bone metastases and SREs in pediatric oncology.
Abstract:
Bone metastases and skeletal-related events (SREs), including radiation therapy or surgery to bone, pathologic fracture, or spinal cord compression, among children have not been described in a population-based study. We examined the rate of bone metastasis, SREs, and survival in the Danish pediatric cancer population. We identified children below 18 years with a first-time diagnosis of cancer between January 1, 1994 and December 31, 2009 in the Danish Cancer Registry. From the Danish National Registry of Patients, we obtained bone metastasis and SRE diagnoses, and estimated incidence rates (IRs). We estimated 6-month, 1-year, and 5-year survival using Kaplan-Meier curves. Of 2652 children, 35 (1.3%) developed bone metastasis during a mean follow-up of 7.0 years (IR=1.9 per 1000 person-years [95% confidence interval (CI), 1.4-2.6]). IRs were substantially higher among children with solid tumors than those with hematologic malignancies (IR=3.2 [95% CI, 2.3-4.6] and IR=0.48 [95% CI, 0.18-1.3]). Survival was poorer for children with bone metastasis than those without bone metastasis. Among children with bone metastasis, 67% experienced an SRE during a mean follow-up of 1.1 years, yielding an IR of 590 per 1000 person-years (95% CI, 381-915). Bone metastases are rare among children with cancer, but SREs are a common consequence.
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