Does the mediastinal lymphadenopathy and hilar mass mean that's metastasized?

Yes, regional metast: If this is a case of lung Cancer, then lymph node spread to the hilar areas and mediastinum means regional spread of cancer. This is still treatable but patient needs to go see a Cancer specialist(Medical Oncologist) at a recognised Cancer Center or Medical center where expert specialists who treat Lung Cancer would be more easily available.