\s=b\Although the presence of squamous cell carcinoma within the peritumoral vascular spaces of primary lesions of the oral cavity and oropharynx has been statistically linked to regional lymph node metastases, the association of this finding with disease control and survival has not been well demonstrated. To evaluate this relationship, we have reviewed the clinical and histopathologic features of 65 consecutive cases of previously untreated T2 or greater squamous cell carcinoma of these sites managed by simultaneous surgical treatment of the primary lesion and regional lymph nodes. Of all the histopathologic features of the primary lesion studied, vascular invasion had the greatest impact on survival, as confirmed by both univariate and multivariate analysis. In addition, vascular invasion correlated statistically with local recurrence, neck recurrence, and distant metastasis. TX 75235-9035 (Dr Close).