Radiation or chemoradiation has been the mainstay of treatment for oropharyngeal squamous cell cancer (OPSCC). In recent years, the increased use of transoral surgery (including transoral robotic surgery and transoral laser surgery) has added complexity to decision making for these patients. This seminar will utilize a tumor board-style discussion to highlight current management algorithms for OPSCC patients, focusing on the decision to treat primarily with or without surgery. Designed for the general otolaryngologist, topics will include the optimal workup for OPSCC including approaches to the unknown primary, patient selection, the role of human papillomavirus (HPV) testing, and a multi-disciplinary review of surgical and non-surgical treatment options. Learning Objectives: 1: Discuss the pros and cons of surgical and non-surgical treatment options for oropharyngeal squamous cell carcinoma (OPSCC). 2: Describe a rational approach to of the workup and treatment of unknown primary OPSCC. 3: Understand ongoing trials in transoral surgery, including potential changes in therapy due to HPV and the emerging role of immunotherapy. Faculty: Tamer Ghanem, MD, PhD, Daniel Clayburgh, MD, PhD, Umamaheswar Duvvuri, MD, PhD, Neil Gross, MD, Julie E. Bauman, MD, MPH,Clifton David Fuller, MD, PhD