Taken together, mutations in the TP53, ATRX, and RB1 genes promote the development, invasion, and metastasis of osteosarcoma, and in Figure 3, the mutation frequency of these three genes is significantly higher in the low-immunity group than in the high-immunity group, indicating that the frequency of metastasis of osteosarcoma is also higher in the low-immunity group, which is in line with the results we obtained above. This evidence concerns the gene ATRX and osteosarcoma.