What is your approach for a locally advanced (stage IVA secondary to N2 disease in the neck), HPV-negative, squamous cell carcinoma of the base of tongue in a patient without significant comorbidities?

In short, we usually do definitive chemorads. However, this question is more complicated than it seems.

With TORS/TLM, surgery seems an option for early Tstage disease, as it is in HPV +ve disease. I believe one of the national studies will try to address this question.

For more advanced T-stage, Eve...