Objective: To investigate the efficacy and safety of postoperative adjuvant transcatheter arterial chemoembolization (TACE) plus portal vein chemotherapy (PVC) for patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT).  
Methods: The clinical data of 119 HCC patients associated with PVTT undergoing surgical treatment from January 2010 to January 2016 were retrospectively analyzed. Of the patients, 64 cases underwent placement of an intravenous chemotherapy pump during operation, and then underwent TACE and PVC through the intravenous chemotherapy pump after operation (TACE+PVC group), and 55 cases did not undergo intravenous chemotherapy pump placement and underwent TACE along after operation (TACE group). The postoperative survival and incidence of postoperative complications of the two groups of patients were observed.
Results: In TACE+PVC group and TACE group, the median disease-free survival (DFS) time and median overall survival (OS) time were 13.3 months vs.6.8 months, and 19.5 months vs.12.5 months, and the 0.5-, 1, 2, and 3-year DFS rates were 71.9% vs.52.9%, 57.5% vs. 26.7%, 16.4% vs.8.2% and 6.9% vs. 2.1%, and OS rates were 90.5% vs. 89.1%, 69.5% vs. 50.4%, 37.9% vs. 12.1% and 22.4% vs. 8.1%, respectively. The median tumor-free survival and median survival time in the TACE group were 6.8 months and 12.5 months, respectively. Both DFS rate and OS rate of TACE+PVC group were significantly higher than those of TACE group (P=0.004 and P=0.001). Results of statistical analysis showed that postoperative treatment method was one of the independent risk factors for postoperative survival of the patients (P<0.05). There were no significant differences in incidence of each specific postoperative complication between the two groups (all P>0.05). 
Conclusion: Postoperative adjuvant TACE plus PVC is safe and effective for patients with HCC and PVTT, and its efficacy is superior to that of TACE alone.