While conflicting results had been reported regarding ovarian cancer, we have shown, in the present study, that strong PAI-1 expression are seen in approximately two-thirds of ovarian cancer samples and PAI-1 expression is an independent prognostic factor among patients with stage II-IV serous adenocarcinoma, suggesting that targeting PAI-1 in ovarian cancer therapy remains an attractive approach particularly in serous adenocarcinoma, the most common and aggressive subtype. The gene discussed is SERPINE1; the disease is serous adenocarcinoma.