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The impact of additional soft tissue resection on oral squamous cell carcinoma (OSCC) recurrence remains controversial. Therefore, the study aim was to compare recurrence between patients with secondary tumour-free resection margins after additional intraoperative resection (STF‐RM) and patients with primary tumour-free resection margins without additional resection (PTF‐RM). Patients with STF‐RM showed lower local and distant control rates compared to patients with PTF‐RM (66.2% vs. 82.8%; p = 0.045 and 86.3% vs. 100.0%; p = 0.021). STF‐RM was the only predictor of local recurrence accounting for tumor (T) status, nodal (N) status, tumor grade, margin distance, and extracapsular extension (hazard ratio 4.21 [95% confidence interval 1.26–14.04]; p = 0.019). STF‐RM have an adverse impact on local and distant recurrence of OSCC.
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