Because Chemoradiation is just as effective killing this type cancer as surgery is, especially with HPV, plus the BOT is integral in swallowing, and can be impaired from surgery, and not function as well or at all, and be debillitating, and surgery can be reserved as a last resort, if needed. The extent of surgery is not really known until it's being done, and can be quite extensive due to the deep musculature of the BOT, and they would have to do the split lip surgery, if not by TORS or Micro laser surgery for small tumors. It's the patients decision too, not that I don't listen, and got several opinions for a recurrence, and wound up taking the 3rd offer that I thought would be the safest, with the best outcome, which was even more aggressive than the first two offers. It's your choice to make an informed decision between the offers, and you have to trust and have faith in your doctor, whoever you choose, and once committed, don't look back or 2nd guess yourself.

Good luck.