The multivariate analysis demonstrated that among the elevated inflammatory markers available, high levels of neutrophil count (p = 0.024; OR = 12.667; 95%CI = 1.402–114.419), ESR (p = 0.009; OR = 19.000; 95%CI = 2.119–170.383), CRP (p < 0.001; OR = 17.000; 95%CI = 3.464–83.436), NLR (p = 0.006; OR = 7.429; 95%CI = 1.778–31.040), and LDH (p = 0.009; OR = 9.333; 95%CI = 2.180–39.962) were associated with the incidence of metastasis in osteosarcoma patients (Table 4). Here, ESR1 is linked to osteosarcoma.