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Objectives: To investigate the natural history of renal cell carcinoma (RCC) with delayed treatment, and immunohistochemically analyzed the correlation between some biomarkers and the growth rate of RCC.Patients and methods: We reviewed our institutional databases to identify renal tumors which were confirmed RCC by delayed surgical treatment after at least 12 months of active surveillance (AS).Growth rate was defined as average growth rate of the maximal diameter on CT or MRI.The clinicopathological characteristics, and immunohistochemical biomarkers (Ki-67, p53, bcl-2, and VEGF) were analyzed the correlation with the growth rate of RCC.