AbstractBackgroundThe impact of additional soft tissue resection on recurrence of oral squamous cell carcinoma (OSCC) remains controversial. The study aim was to compare recurrence between patients with secondary tumor‐free resection margins after intraoperative additional resection (STF‐RM) and patients with primary tumor‐free resection margins without additional resection (PTF‐RM).MethodsForty‐five patients with STF‐RM were matched with patients with PTF‐RM according to Union for International Cancer Control stage, tumor location, and treatment modality and compared for local, regional, and distant recurrence.ResultsPatients 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).ConclusionsSTF‐RM have an adverse impact on local and distant recurrence of OSCC.