This is Episode 18: TORS and De-Escalation. Today we tackle one of the most controversial and actively evolving areas in head and neck oncology: the role of transoral robotic surgery and treatment de-intensification for H-P-V-positive oropharyngeal cancer. This is exceptionally high-yield for boards because examiners love to test whether you can distinguish proven standards from promising-but-investigational strategies. Here is the core tension you must understand: H-P-V-positive oropharyngeal cancer hasan excellent prognosis with standard chemoradiation, with five-year overall survival exceeding eighty-five percent. This favorable biology has generated enormous enthusiasm for de-escalation, meaning reducing treatment intensity to preserve function while maintaining cure. But enthusiasm is not evidence. Multiple de-escalation strategies have failed in Phase Three testing, and the examiner will probe whether you know the difference between what is proven and what remains investigational. By the end of this episode, you will be able to articulate TORS candidacy criteria, navigate the E-C-O-G-A-C-R-I-N E-three-three-eleven risk stratification system, explain why N-R-G H-N-zero-zero-five closed its dose-reduced arm, and deliver board-safe answers that acknowledge nuance without overstating evidence.