This study was designed to investigate the prognostic significance of the expression of paired epithelial cell adhesion molecule and E-cadherin in ovarian serous carcinoma. The expression of epithelial cell adhesion molecule and E-cadherin was examined immunohistochemically on a tissue microarray of formalin-fixed paraffin-embedded tissue specimens from 72 consecutive patients. The overexpression of epithelial cell adhesion molecule was correlated with poor survival (P = .036). In contrast, the reduced expression of E-cadherin was correlated with poor survival (P = .034). When patients were subclassified into 4 groups according to positivity and negativity of epithelial cell adhesion molecule and E-cadherin expression, the epithelial cell adhesion molecule-positive E-cadherin-negative group showed the worst survival rate (P = .002, compared with the epithelial cell adhesion molecule-negative E-cadherin-positive group). These data suggest that the overexpression of epithelial cell adhesion molecule and reduced expression of E-cadherin in combination is more significant than a single marker for predicting poor survival.