In patients with metastatic tumors, PAX3::FOXO1 and PAX7::FOXO1‐positive aRMS had significantly worse EFS and OS compared to patients with eRMS in contrast to patients with FN aRMS whose EFS and OS were much better but did not reach statistical significance (5 year EFS 71% vs. 45%, 5 year OS 70%vs. Here, FOXO1 is linked to metastatic neoplasm.