Over 250,000 cases of oral squamous cell carcinomas are diagnosed annually worldwide with 128,000 registered deaths. The authors of this study are from a single institution in Germany and have conducted a retrospective audit of 517 patients with oral SCC from 2003-2013. Recurrence was diagnosed in 13.3% of patients. The authors found a significant correlation between recurrence and number of resected nodes, positive nodal disease, postoperative radiation, extracapsular spread and grading. They identify poorly differentiated oral SCC as an independent risk factor for recurrence and even quantify the risk as being two-fold of well or moderately differentiated tumours. Another interesting association is postoperative radiation. Whereas postoperative radiotherapy is usually given for patients with locally advanced disease, in this study they confirm a higher rate of recurrence and suggest as an explanation radiation causing DNA damage locally. Vascular invasion and particularly lymphatic vessel invasion is an accepted risk factor and yet in this study, there are no significant associations. The authors suggest this might be due to the smaller size of the study. This is an excellent paper that is well worth reading to understand the current discussion on risk factors for oral SCC recurrence.