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

Inclusion Criteria: * Histologically proven squamous cell carcinoma of the oropharynx * Clinical stage T1-2, N0-N3, M0 by American Joint Committee on Cancer (AJCC) 8 criteria * Must have tumors deemed surgically resectable with acceptable morbidity * Estimated life expectancy of at least 12 weeks * Must give informed consent * Must have Eastern Cooperative Oncology Group (ECOG) performance status =\< 3 * Must have detectable circulating HPV DNA levels * Platelets \>= 100,000/ul * Absolute neutrophil count (ANC) \>= 1,500/ul * Hemoglobin \> 8 g/dl (use of transfusion to achieve this is acceptable) * Total bilirubin \< 2 X institutional upper limit of normal (ULN) * Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase \[SGOT\])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) \< 3 X institutional ULN * Serum creatinine \< 2 x institutional ULN or creatinine clearance \> 50 ml/min as determined by 24 hour collection or estimated by Cockcroft-Gault formula * Negative pregnancy test, if applicable Exclusion Criteria: * Patients may not have received previous therapy for their head and neck squamous cell carcinoma (SCC), including chemotherapy, radiation therapy, or surgery beyond biopsy * Second primary malignancy. Exceptions are: * Patient had a second primary malignancy but has been treated and disease free for at least 3 years * In situ carcinoma (e.g. in situ carcinoma of the cervix) * Non-melanomatous carcinoma of …