Nichols AC, Theurer J, Prisman E, et al. - In an investigator-initiated, multicenter, international, open-label, parallel-group, phase 2, randomized study, researchers compared quality of life (QOL) 1 year posttreatment among patients aged 18 years or older with Eastern Cooperative Oncology Group scores of 0–2, and with T1–T2, N0–2 (≤ 4 cm) oropharyngeal squamous cell carcinoma (OPSCC) tumor types randomized (1:1) to radiotherapy (70 Gy, with chemotherapy if N1–2) vs transoral robotic surgery plus neck dissection (with or without adjuvant chemoradiotherapy, based on pathology). In Canada and Australia, patients were enrolled at six hospitals. Randomization of patients, post-stratification by p16 status, was done using a computer-generated randomization list with permuted blocks of four. At 1-year posttreatment, better swallowing-related QOL scores were reported in patients who had radiotherapy, although the difference was not clinically meaningful. The groups showed different toxicity patterns. Informing patients with OPSCC regarding both treatment options was recommended.