My CCC, Mt Sinai, plan of action for stage 4 tonsil and bot was to do 3 cycles of induction chemo first, IC, followed by chemoradiation for 7 weeks, and surgery as a last resort, also called salvage surgery. I believe MSKCC, usually like to do surgery first, not afterwards, based on an a discussion video I seen by Dr Lee, but that could be dated, and never consulted there myself, in person. Each case is different, HPV, non HPV, the TNM grading like the tumor size, location of tumor, number/size of lymph nodes, and so is the patients request taken into consideration, even doctors are different, and probably most do well with just CRT.

Surgery is also more difficult after radiation due to inflammation, necrosis, and usually need longer healing time, and may have more complications, and some do a planned neck dissection after CRT, based on TN, usually before 6 weeks, wether or not cancer is present, which shows better outcome.

In retrospect, I wish I had a neck dissection first. I never made it past the induction phase in 2009, had to stop treatment for over a year at stage 4, which is the cause of all my recurrences. Good luck.