Swallowing Outcomes and Circulating Tumor DNA in Patients With HPV Related Oropharyngeal Cancer Treated With Transoral Surgery and Reduced Intensity Adjuvant Therapy

Patients will undergo transoral surgery

Patients in Group II and Group III will undergo External Beam Radiation Therapy (EBRT) RT following transoral surgery.

Patients in Group III will receive cisplatin, 30 mg/m2, administered intravenously weekly per for 6 weeks.

Incisional biopsy of the primary tumor site will be required to confirm p16/HPV status of the tumor

Assess ctDNA levels at baseline, 2 weeks, 4 weeks, 10 weeks, 24 weeks and 1 year after the surgery.

MDADI is a 20 item quality of life questionnaire specifically focusing on swallowing aspects. It was originally designed for head and neck cancer patients. The total score ranges from 20 to 100 with the higher score indicating higher level of function.

University of Washington Questionnaire is a 15 item quality of life instrument specifically designed for head and neck cancer patients.

A generic quality of life and cost utility instrument widely used and validated for multiple disease settings, including head and neck cancer.

"The videofluoroscopic modified barium swallow (MBS) study is the gold standard for for the evaluation of dysphagia, and specifically, airway protective mechanisms.~The penetration/aspiration (PEN/ASP) scale is a routinely used eight-point scale designed to describe the depth of bolus penetration into the airway and the patient response to the penetration or aspiration."