For oral T1-T2, radiation is also an alternative to surgery, per NCCN guidelines, but haven't seen many go this route mono treatment for the oral tongue. Another treatment is trans oral micro laser surgery, which can be done again, if needed, as opposed to other treatments, and does not interfere with future surgery or radiation.

If its HPV related, 90% of the time it's the oropharynx, like BOT, which can metastasize to the oral tongue, and usually not the other way around. That 10% could include patients who were misdiagnosed, as researchers shown happened, when they went back to review medical files, diagnostic tests of HPV oral cancer patients, to find they really had oropharynx cancer to begin with. Oropharynx HPV related also can be an unknown primary from the virus killed off by the body's immune system, but still metastasize before that or when it metastasizes, it basically kills off the primary, when metastasizing to the lymph nodes.

You could just be that 10%, but I would like to double check.